Incidence and Risk Factors for Lumbar Degenerative Disc Disease in the United States Military 1999–2008

Department of Orthopedic Surgery, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920, USA.
Military medicine (Impact Factor: 0.77). 11/2011; 176(11):1320-4. DOI: 10.7205/MILMED-D-11-00061
Source: PubMed


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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    • "IDD is perhaps best defined as a cascade that begins with changes to the cellular microenvironment and progresses to the structural breakdown and functional impairment of the intervertebral disc [6]. Aging, living conditions, biomechanical loading and genetic factors are often related to disc degeneration [7,8]. Prominent changes occurring during IDD are characterized by a decrease of active cell numbers, depletion of extracellular matrix, altered phenotype of normal disc cells, and the presence of pro-inflammatory cytokines and mediators [9,10]. "
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