若年期に生じた腰痛の自然経過

Natural Course of Low Back Pain in Adolescence

　抄録：われわれは10年以上前に腰痛を訴え，MRIで椎間板障害を認めた10代の若年者222例のうち，今回再度MRIを撮影できた33症例，165椎間板を対象として前回と比較，検討した．MRIにて椎間板変性，椎間板ヘルニア，終板障害，椎間板腔狭小化を，臨床症状に対してはJOAスコアなどを検討した．椎間板変性は29症例，62椎間板に認められ，変性は進行していることが多かったが，椎間板ヘルニアは29症例，46椎間板であり，経時的に進行したのは3椎間板のみであった．終板障害は8例，17椎間に，椎間板腔狭小化は9椎間に認められた．JOAスコアは平均26.3±1.99と良好であり，腰痛の自覚症状は前回に比べて改善22例，不変8例，悪化3例であった．若年期に変性を認めた椎間板変性は進行するものの臨床症状は進行していないことが明らかとなった．しかし，さらに今後も注意深く調査していく必要があると考えられる．

　In this study we assessed low back pain in patients whose pain had originated in adolescence and persisted for more than ten years. The purpose of the study was to determine how the pain changed and to conduct a comparative study based on MRI findings and the results of clinical examinations.

　A total of 222 patients who had first experienced low back pain more than ten years previously when they were under 20 years old attended our clinic and the subject group of the study consisted of the 33 patients who underwent MRI. The focus of our study was disc degeneration, disc herniation, lumbar endplate lesions, and narrowing of the disc space, and we evaluated clinical symptoms by using Japanese Orthopaedic Association (JOA) score for low back pain. We also investigated the relationship between low back pain and sports activities.

　The disc degeneration in this group had gradually progressed, but the clinical symptoms had not become significantly worse.