Factors associated with lumbar intervertebral disc degeneration in the elderly.

Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Ten-nodai, Tsukuba, Ibaraki, 305-8575, Japan.
The Spine Journal (Impact Factor: 2.8). 12/2007; 8(5):732-40. DOI: 10.1016/j.spinee.2007.07.392
Source: PubMed

ABSTRACT Lumbar intervertebral disc degeneration (DD) precedes degenerative diseases of the lumbar spine. Various factors in addition to normal aging are reported to be associated with DD, and recently atherosclerosis and risk factors for cardiovascular diseases (cardiovascular risk factors) have received much attention; however, the links between these risk factors and DD are unclear.
By correlating magnetic resonance images (MRI) with suspected degenerative disc risk factors such as obesity, cardiovascular risk factors, and atherosclerosis, we hope to clarify the factors associated with DD.
An observational study.
Two hundred seventy adults (51-86 years old) who participated in a health promotion program.
DD evaluated based on the signal intensity of MR T2-weighted mid-sagittal images of the lumbar spine.
Age, gender, body mass index (BMI), low-density lipoprotein cholesterol (LDLc), triglyceride (TG), glycosylated hemoglobin (HbA(1c)), brachial-ankle pulse wave velocity (baPWV) as an index of atherosclerosis, osteo-sono-assessment index (OSI) calculated from quantitative ultrasound assessment of the calcaneus as an index of bone mineral density (BMD), history of low back pain (LBP), smoking and drinking habits, and physical loading related to occupations and sports were assessed. The univariate relationships between DD and the variables were evaluated, and finally, odds ratios (OR) and 95% confidence intervals (CI) for the associations of each factor with DD were calculated using logistic regression at each disc level.
Aging correlated significantly with DD of L1/2 (OR, 2.14), L2/3 (OR, 3.56), L3/4 (OR, 2.84), and L4/5 (OR, 3.05); high BMI, with L2/3 (OR, 2.98), L3/4 (OR, 3.58), L4/5 (OR, 2.32), and L5/S1 (OR, 3.34); high LDLc, with L4/5 (OR, 2.65); occupational lifting, with L1/2 (OR, 4.25); and sports activities, with L5/S1 (OR, 3.36).
Aging, high BMI, high LDLc, occupational lifting, and sports activities are associated with DD. The results of this study raise our index of suspicion that cardiovascular risk factors and particular physical loading may contribute to DD; however additional studies are required to further investigate associations between DD and these factors.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Musculoskeletal disorders are prevalent among airline baggage handlers due to manual material handling. In this study, the Nordic questionnaire, the Revised NIOSH Lifting Equation, and University of Michigan's 3D Static Strength Prediction Program TM (3DSSPP) were used to analyze musculoskeletal disorders among baggage handlers. Methods: Nordic questionnaire was filled out by 209 baggage handlers and also 46 arbitrarily selected baggage handlers were evaluated using the NIOSH method and 3DSSPP. Results: The obtained results showed that the most common musculoskeletal disorder occurred in the low back region. The next risky regions included knees, neck, and upper back, respectively. The NIOSH results confirmed that the subjects lifted loads heavier than the permitted limit and their lifting postures were inappropriate. Results of 3DSSPP also indicated that compression forces exceeded the NIOSH limit in these awkward postures. Conclusions: Relying on this study, holding compulsory ergonomic lifting training courses could be proposed for workers and regulations adjusting upper limit for maximum baggage weight must be also enacted in order to improve occupational health and prevent the prevalence of increasing musculoskeletal disorders.
    International journal of occupational safety and ergonomics: JOSE 12/2015; · 0.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: In Part 1 of this paper, we presented a comprehensive review of the literature, regarding pathophysiology of discogenic pain. Based on the evidence presented, we are suggesting clinical, self-management strategies to promote disc healing and treat disc pain in general. Objectives: To suggest a physical therapy protocol for self-management of disc injuries and stimulation of disc healing. Major findings: Inflammatory process after injury to the outer annulus is the most likely source of discogenic pain. Annulus is the tensile load bearing ‘skin’ of the disc and its histology and pathology are similar to other collagen tissues like tendons and ligaments. Conventional physiotherapy wisdom for the management of tendon and ligament injuries is applicant to annular tears. Disc pain without injury is common due to development of stress concentrations in the disc especially during prolonged, end-range postures. Spinal motion segment depends on an optimal disc function. Strategies for management of associated pathologies like apophyseal joint pain and muscle spasm are also considered on this paper. Conclusion: Physical therapies should aim to promote healing in the disc periphery, by stimulating cells, boosting metabolite transport, discouraging adhesion formation, and preventing re-injury. The self-treatment approach presented in this paper, can potentially provide pain relief to a large number of back pain sufferers. This approach can be applied through information sessions and classes to help deal with the widening back pain pandemic.
    Physical Therapy Reviews 02/2013; 18(1):34-42. DOI:10.1179/1743288X12Y.0000000038
  • Source
    Sinapse 11/2012; 12(2):11.

Full-text (2 Sources)

Available from
May 23, 2014