Incidence and risk factors for lumbar degenerative disc disease in the United States military 1999-2008.
ABSTRACT The epidemiology of lumbar degenerative disc disease (DDD) is poorly understood, and the incidence of this disorder has not previously been characterized for a young, physically active population. This study sought to evaluate the incidence of lumbar DDD, and identify risk factors for its development, among individuals serving in the U.S. military over a 10-year period. The Defense Medical Epidemiology Database was queried for the years 1999-2008 using the International Classification of Diseases, Ninth Revision, Clinical Modification code for lumbar disc degeneration (722.52). Overall incidence was determined and multivariate Poisson regression analysis was performed to identify risk factors among demographic characteristics such as age, sex, race, military rank, and branch of service. White race, female sex, Army, Air Force, or Marine service, enlisted positions within the ranks, and age were found to be significant risk factors for the development of lumbar disc degeneration. Increased age appeared to be one of the most important risk factors, with adjusted incidence rates successively increasing for each age group under study. The incidence of lumbar DDD in this young, racially diverse, and physically active population is higher than most other degenerative conditions.
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ABSTRACT: The purpose of this article is to report the response of chiropractic care of a geriatric veteran with degenerative disk disease and diffuse idiopathic skeletal hyperostosis. A 74-year-old man presented with low back pain (LBP) and loss of feeling in his lower extremities for 3 months. The LBP was of insidious onset with a 10/10 pain rating on the numeric pain scale (NPS) and history of degenerative disk disease and diffuse idiopathic skeletal hypertrophy. Oswestry questionnaire was 44% and health status questionnaire was 52%, which were below average for his age. The patient presented with antalgia and severe difficulty with ambulation and thus used a walker. Chiropractic care included Activator Methods protocol. Two weeks into treatment, he reported no back pain; and after 4 treatments, he was able to walk with a cane instead of a walker. The NPS decreased from a 10/10 to a 0/10, and his Revised Oswestry score decreased from 44/100 to 13.3/100. His Health Status Questionnaire score increased 25 points to 77/100, bringing him from below average for his age to above average for his age. Follow-up with the patient at approximately 1 year and 9 months showed an Oswestry score of 10/100 and a Health Status Questionnaire score of 67/100, still above average for his age. The findings in this case study showed that Activator-assisted spinal manipulative therapy had positive subjective and objective results for LBP and ambulation in a geriatric veteran with degenerative disk disease and diffuse idiopathic skeletal hyperostosis.Journal of chiropractic medicine 12/2012; 11(4):293-299.
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ABSTRACT: This study aimed to investigate whether or not hypoxia-inducible factor-1α (HIF-1α) gene variants are associated with the susceptibility and clinical characteristics of lumbar disc degeneration (LDD). We examined 320 patients with LDD and 447 gender- and age-matched control subjects. We also determined the HIF-1α gene variants, including C1772T (P582S) and G1790A (A588T) polymorphisms. Significant differences were observed in allelic and genotypic distributions of 1790 A > G polymorphisms between LDD cases and control subjects. Logistic regression revealed that 1790 AA genotypes indicated a protective effect against the development of LDD. The HIF-1α 1790 A > G polymorphisms also affected the severity of LDD as evaluated based on the modified Japanese Orthopedic Association (mJOA) scores. The 1790 AA genotype carriers exhibited significantly lower mJOA scores than AG and GG carriers. C1772T did not show any association with the risk and severity of LDD. Our study suggested that HIF-1α 1790 A > G polymorphisms may be used as a molecular marker to determine the susceptibility and severity of LDD.PLoS ONE 01/2013; 8(8):e73158. · 3.73 Impact Factor