Young Investigator Award 2001 winner: Risk factors for lumbar disc degeneration - A 5-year prospective MRI study in asymptomatic individuals
Young Investigator Award 2001 winner: Risk factors for lumbar disc degeneration - A 5-year prospective MRI study in asymptomatic individuals
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DOI：
10.1097/00007632-200201150-00002
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发表时间：
2002-01-15
期刊：
影响因子：
3
通讯作者：
Boos, N
中科院分区：
文献类型：
--
作者：
Elfering, A;Semmer, N;Boos, N
研究设计。对无症状个体的腰椎间盘退变进行了纵向磁共振成像研究。探讨腰椎间盘退变发生或恶化的危险因素。背景资料摘要。许多研究探讨了某些危险因素对椎间盘退变发生或进展的意义，但尚未有基于纵向磁共振成像的综合研究同时考虑临床、形态学、生理、社会心理和职业危险因素。在对41例无症状患者的5年随访评估中，研究了腰椎间盘退变发生及其进展的危险因素。所有41名患者在基线和至少5年随访评估时使用相同的扫描仪和方案进行了磁共振成像扫描。磁共振图像由两名放射科医生独立分析椎间盘退变。在基线和随访中评估了各种预测变量，特别强调身体工作特征，体育活动和基于磁共振成像的形态学发现。41例患者中，17例（41%）表现为椎间盘状态恶化。在10例患者中，椎间盘退变的进展为一级或一级以上。在5年随访期间，进行性椎间盘退变与腰痛发展之间仅存在弱相关性。多元logistic回归分析显示，椎间盘突出程度（优势比[OR]， 12.63；置信区间[CI]， 1.24-128.49）、缺乏体育活动（OR, 2.71; Cl, 1.04-7.07）和夜班工作（OR, 23.01; Cl, 1.26-421.31）是随访评估时椎间盘退变的重要预测因素，对照组为基线时退变的椎间盘数量、性别、年龄和体重指数。结果表明，腰椎间盘突出程度、缺乏体育活动和夜班工作是腰椎间盘退变发生及其进展的重要危险因素。
Study Design. A longitudinal magnetic resonance imaging investigation of lumbar disc degeneration in asymptomatic individuals was conducted.Objective. To investigate risk factors for the development or deterioration of lumbar disc degeneration.Summary of Background Data. Numerous studies have explored the significance of certain risk factors for the development or progression of disc degeneration, but no comprehensive longitudinal magnetic resonance imaging-based study has been reported that simultaneously considers clinical, morphologic, physical, psychosocial, and occupational risk factors.Methods. In the 5-year follow-up evaluation of 41 asymptomatic individuals, the risk factors for the development of lumbar disc degeneration and its progression were investigated. All 41 individuals had a magnetic resonance imaging scan at baseline and at the minimum 5-year follow-up assessment using the same scanner and protocol. The magnetic resonance images were analyzed independently by two radiologists with regard to disc degeneration. Various predictor variables were assessed both at baseline and follow-up, with special emphasis on physical job characteristics, sports activities, and magnetic resonance image-based morphologic findings.Results. Of the 41 individuals, 17 (41%) exhibited a deterioration of the disc status. In 10 individuals, the progression of disc degeneration was one grade or more. Only a weak correlation existed between progressive disc degeneration and low back pain development during a 5-year follow-up period. Multiple logistic regression analysis demonstrated that the extent of disc herniation (odds ratio [OR], 12.63; confidence interval [CI], 1.24-128.49), the lack of sports activities (OR, 2.71; Cl, 1.04-7.07), and night shift work (OR, 23.01; Cl, 1.26-421.31) were significant predictors for disc degeneration during follow-up evaluation when control was used for the number of degenerated discs at baseline, gender, age, and body mass index.Conclusions. The results indicate that the extent of disc herniation, the lack of sports activities, and night shift work are significant risk factors for the development of lumbar disc degeneration and its progression.