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Fatores determinantes entre dor na coluna vertebral e a sua rela??o com achados radiol?gicos em idosos

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Previous issue date: 2017-02-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Spinal pain is a very common complaint in aging and it is associated with several problems that can be identified in radiological examinations. However, at clinical practice, there may be some variance related to radiological findings and to pain intensity felt by the elderly. Objective: Identify the contributing factors of pain in the spine through radiological findings in the elderly. Methods: An observational, descriptive, analytical cross-sectional study that included elderly individuals with radiological findings related to pain in the spine. The evaluation was performed through a semi-structured questionnaire, followed by an evaluation of the general health perception through the WHOQOL-Bref questionnaire, by the pain level evaluation using the Visual Analogue Pain Scale, by the evaluation of the pain-related functional disability by the Oswestry questionnaire, by a screening of depressive symptoms through the Geriatric Depression Scale (EDG) and by the index of radiological changes, from March to November 2017, in Farroupilha, RS - Brazil. For the correlations, the univariate and multivariate regressions were considered, as well as the chi-square test, and also considered a significance of 5%. The study was approved by PUCRS Ethical Research Committee, under the number 64103416.7.0000.5336. Results: A total of 101 elderly individuals aged between 60 and 91 were included. Life satisfaction was progressively worse for higher levels of pain (p=0,034); osteoarthritis (p=0,030) and diabetes (p=0,039) were related with higher and lower pain intensity, respectively. The most common radiological alterations were decreased disc space (100%), osteophytes (98%) and arthrosis (74%). The alterations related to worse pain levels were arthrodesis (p<0,001), spondylolisthesis (p=0,003), stenosis of the foraminal canal (p=0,015) and hyperkyphosis (p=0,046). The disability was worse at higher levels of pain (p<0,001). The radiological changes related to disability were: arthrosis (p=0,012); arthrodesis (p=0,013); scoliosis (p<0,001); spondylolisthesis (p=0,010); stenosis of the foraminal canal (p=0,035), and osteophytes (p=0,003). The age factor is related to worse levels of disability (p=0,022). Conclusion: The study showed that the intensity of pain is associated with present radiological changes. More severe pain causes greater levels of disability, in which most advanced age and radiological changes that were seen in X ray should be taken into account as they may influence disability. / Introdu??o: A dor na coluna vertebral ? uma queixa comum no envelhecimento e est? associada a diversos fatores que podem ser identificados em exames radiol?gicos. No entanto, na pr?tica cl?nica, podem ocorrer discrep?ncias em rela??o aos achados radiol?gicos visualizados e ? intensidade da dor percebida pelo idoso. Objetivo: Identificar os fatores contribuintes de dor na coluna vertebral com achados radiol?gicos em idosos. M?todos: Estudo transversal observacional descritivo anal?tico que incluiu indiv?duos idosos com achados radiol?gicos relacionados ? dor na coluna vertebral. A avalia??o foi realizada por meio de um question?rio semiestruturado, seguido de uma avalia??o da percep??o de sa?de geral por meio do question?rio WHOQOL-Bref, da avalia??o do n?vel de dor utilizando a Escala Visual Anal?gica da dor, da avalia??o da incapacidade funcional relacionada ? dor pelo question?rio Oswestry, de um rastreio de sintomas depressivos por meio da Escala de Depress?o Geri?trica (EDG) e do ?ndice de altera??es radiogr?ficas no per?odo de mar?o a novembro de 2017 em Farroupilha, RS ? Brasil. Para as correla??es, foram realizadas a regress?o univariada e multivariada, bem como qui-quadrado e considerada signific?ncia de 5%. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da PUCRS sob o n?mero 64103416.7.0000.5336. Resultados: Foram inclu?dos 101 idosos entre 60 e 91 anos. A satisfa??o de vida foi progressivamente pior para n?veis mais elevados de dor (p=0,034); artrose (p=0,030) e diabetes (p=0,039) foram relacionadas com maior e menor intensidade da dor percebida, respectivamente. As altera??es radiol?gicas mais comuns foram espa?o discal diminu?do (100%), oste?fitos (98%) e artrose (74%). As altera??es relacionadas a piores n?veis de dor foram a artrodese (p<0,001), espondilolistese (p=0,003), estenose do canal foraminal (p=0,015) e hipercifose (p=0,046). A incapacidade foi relacionada a n?veis mais elevados de dor (p<0,001). As altera??es radiol?gicas relacionadas ? incapacidade foram: artrose (p=0,012), artrodese (p=0,013), escoliose (p<0,001), espondilolistese (p=0,010), estenose do canal foraminal (p=0,035) e oste?fitos (p=0,003). A faixa et?ria mais avan?ada mostrou rela??o com piores n?veis de incapacidade (p=0,022). Conclus?o: O estudo evidenciou que a intensidade de dor percebida pelo idoso est? associada a altera??es radiol?gicas presentes. A dor mais intensa causa maiores n?veis de incapacidade, onde a idade mais avan?ada e as altera??es radiol?gicas visualizadas ao Raio X devem ser levadas em considera??o, podendo influenciar no aspecto da incapacidade.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7943
Date28 February 2017
CreatorsPessin, Jonathan Loro
ContributorsSchneider, Rodolfo Herberto
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Escola de Medicina
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS
Rightsinfo:eu-repo/semantics/openAccess
Relation4438661476953179033, 500, 600, 500, 600, -224747486637135387, -969369452308786627, 2075167498588264571

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