ORIJINAL ARAŞTIRMA
Kronik Bel Ağrılı Hastalarda Büyük Trokanterik Ağrı Sendromunun Sıklığı ve Etkileri: Kesitsel Çalışma
Frequency and Effects of Great Trochanteric Pain Syndrome in Patients with Chronic Low Back Pain: A Cross-Sectional Study
Received Date : 11 May 2022
Accepted Date : 01 Sep 2022
Available Online : 26 Sep 2022
Hanife ÇAĞLAR YAĞCIa, Yasemin YUMUŞAKHUYLUb, İlker YAĞCIc
aClinic of Physical Medicine and Rehabilitation, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
bDepartment of Physical Medicine and Rehabilitation, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Türkiye
cDepartment of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye
Doi: 10.31609/jpmrs.2022-91291 - Makale Dili: EN
J PMR Sci. 2023;26(1):73-9
ÖZET
Amaç: Büyük trokanterik ağrı sendromu (BTAS), bel, kalça ve diz
hastalıklarında da sık görülmektedir. Çalışmanın amacı, kronik bel ağrılı
(KBA) hastalarda BTAS sıklığını saptamak, BTAS’nin klinik etkilerini ortaya
koymak ve BTAS gelişimine etki eden faktörleri belirlemektir. Gereç
ve Yöntemler: KBA ile başvuran hastalar standardize edilmiş öykü ve fizik
muayene ile değerlendirilmelerinin ardından lomber ön-arka, lomber yan
grafiler ve lomber manyetik rezonans görüntülemeleri ile değerlendirildi.
Tüm hastalara Oswestry Dizabilite Anketi (ODA), Kısa Form-36 [Short
Form-36 (SF-36)] dolduruldu. Bulgular: KBA hastalarda %59,2 oranında
BTAS saptanmıştır. BTAS varlığı görsel analog skala ile ölçülen ağrı
düzeyini artırmakta iken OBA ile ölçülen fonksiyonel durumu
kötüleştirmektedir (p=0,007, p=0,001). BTAS varlığı SF-36 ağrı alt parametresinde
bozulmaya neden olmaktadır (p=0,005). Kadın cinsiyet bir risk faktörü
olarak saptanırken (p=0,031), BTAS’li hastalarda yürüme bozukluğu ve
nörojenik kladikasyon daha fazla bulunmuştur (p=0,021, p=0,017). BTAS
hastalarında osteofit, skleroz, intervertebral disk mesafesi kaybı ve santral
spinal dar kanal daha sıktır (p=0,021, p=0,011, p=0,05, p=0,021) Sonuç:
KBA’lı hastalarda BTAS oldukça sık rastlanan, ağrılı bir durumdur.
Kadınlarda, dejeneratif durumun daha ağır olduğu hastalarda ve santral
spinal dar kanalı olan hastalarda daha sık görülebilmektedir. Ağrı düzeyini
artırmakta ve yaşam kalitesini olumsuz etkilemektedir.
Anahtar Kelimeler: Büyük trokanterik ağrı sendromu; kronik bel ağrısı; yaşam kalitesi
ABSTRACT
Objective: Greater trochanteric pain syndrome (GTPS) can
be commonly seen in patients with low back, hip or, knee pain. The aims of
the study are to determine the frequency of GTPS in patients with chronic
low back pain (CLBP), to reveal the clinical effects of GTPS and to identify
the risk factors for the development of GTPS. Material and Methods:
Patients with CLBP were evaluated with standardized history and physical
examination. Oswestry Disability Index (ODI) and Short Form-36 (SF-36)
were used for the asessment of quality of life. Patients were assessed with
lumbar anteroposterior, lumbar lateral radiographs, and lumbar magnetic
resonance imaging. Results: GTPS was detected in 59.2% of patients with
CLBP. The presence of GTPS increased the pain level measured by visual
analog scale, it worsens the functional status measured by ODI (p=0.007,
p=0.001). Presence of GTPS caused deterioration in SF-36 pain subparameter
(p=0.005). While female gender was found to be a risk factor
(p=0.031), gait disturbance and neurogenic claudication were found to be
more common in patients with GTPS (p=0.021, p=0.017). Osteophytes, sclerosis,
loss of intervertebral disc space, and central spinal stenosis were common
in patients with GTPS (p=0.021, p=0.011, p=0.05, p=0.021).
Conclusion: GTPS was a very common and painful condition in patients
with CLBP. It was seen more frequently in women, in patients with a more
severe degenerative condition, and with central spinal stenosis. GTPS increased
the level of pain and negatively affects the quality of life.
Keywords: Greater trochanteric pain syndrome; chronic low back pain; quality of life
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