青少年颈痛患者颈部椎旁压痛点分布规律与临床意义OA

Objective To investigate the distribution pattern and clinical significance of neck paravertebral tender points in adolescents with neck pain.Methods Using a case-control study method,45 adolescents with neck pain who met the relevant standards were enrolled as the observation group,and 45 asymptomatic adolescents as the control group.Neck paravertebral tender points in both groups were collected via palpation and compared.The distribution pattern of tender points in the observation group was analyzed,and its correlation with imaging findings was evaluated.Results ①There were no statistically significant differences between the two groups in baseline characteristics such as gender and age(P>0.05),indicating comparability.② Paravertebral tender points were present in approximately 97.78%of the subjects in the observation group.The difference in the incidence of paravertebral tender points between the two groups was statistically significant(P<0.05).③ Distribution pattern in the observation group:tenderness at facet joints was the most common,especially at the C2～C3 facet joint(86.67%);followed by transverse process tenderness,predominantly at the C2 transverse process(64.44%);and spinous process tenderness,mainly at the C4 spinous process(37.78%).④Kappa test showed good consistency between palpation findings of paravertebral tenderness and abnormal imaging changes in the upper cervical spine(C1～C2)(Kappa=0.723,P=0.001),moderate consistency in the middle cervical spine(C3～C5)(Kappa=0.571,P=0.001),and good consistency in the lower cervical spine(C6～T1)(Kappa=0.641,P=0.001).Conclusion Paravertebral tender points in adolescents with neck pain are mainly distributed at the facet joints,transverse processes and spinous processes of the upper and middle cervical spine.The occurrence of tender points is often associated with pathological changes of local vertebral joint malalignment.