【摘要】 目的分析全膝关节置换术后非特异性下腰痛原因。方法选取2011年3月~2013年3月在我科行全膝关节置换术后出现非特异性下腰痛的93例患者作为研究对象,术前术后分别行膝关节HSS评分,测量腰椎生理曲度(腰椎前凸角、骶骨前倾角),术后对非特异性下腰痛者行Oswestry功能障碍指数(ODI)问卷调查。结果患者术后的膝关节HSS评分明显高于术前(P<0.05);术后的腰椎前凸角、腰椎前凸角与术前比较,差异有统计学意义(P<0.05)。膝关节HSS评分、腰椎前凸角、骶骨倾斜角术前术后差值与ODI呈正相关(r=0.723、0.831、0.695)。结论全膝关节置换术后,膝关节功能改善,下肢力线改变,导致脊柱负重力线改变,腰椎生理曲度(腰椎前凸角、骶骨倾斜角)发生改变,腰椎原有的平衡被打破,在建立二次平衡前,因腰椎不稳出现下腰痛。更多还原

【Abstract】 Objective To analyze the cause of non-specific lower back pain after total knee arthroplasty. Methods From March 2011 to March 2013,93 patients with non-specific lower back pain occurred after total knee arthroplasty were selected as research object.HSS score of knee joint was conducted,physiological curvature of the spine(lumbar lordotic angle,sacral inclination angle) was measured before and after operation.After operation,patients with non-specific lower back pain after total knee arthroplasty was surveyed by Oswestry disability index(ODI) questionnaire.Results HSS score of knee joint after operation Was significantly higher than that before operation(P<0.05);there was a statistical difference of lumbar lordotic angle,sacral inclination angle after operation compared with before operation(P<0.05).The difference of HSS score of knee joint,lumbar lordotic angle,sacral inclination angle before and after operation was positively correlated with ODI(r =0.723,0.831,0.695). Conclusion After total knee arthroplasty,function of knee joint improved and lower limb force line changed leads to the change of spinal loading force line,and physiological curvature of the spine(lumbar lordotic angle,sacral inclination angle),then the original balance of the lumbar spine is broken,before the establishment of two balance,lower back pain appears because of lumbar instability.更多还原