Regression Model for Socio-demographic, Behavioural and Occupational Risk Factors in Lumbar Disc Herniation (LDH) and Lumbar Disc Degeneration (LDHD)-In Comparison to Apparently Healthy Subjects.

2021 ◽  
Vol 5 (4) ◽  
pp. 424
Author(s):  
ND Withanage ◽  
S Perera ◽  
H Peiris ◽  
S Prathapan ◽  
LV Athiththan

Objective: Present study was aimed to develop a regression model for selected sociodemographic, behavioural and occupational factors with lumbar disc herniation (LDH) and lumbar disc hearniation and degeneration (LDHD) in a selected population in comparison to healthy individuals.Materials & Methods: The study was conducted using 104 cases with disc herniation and controls (n=104) without LDH. Analysis was conducted in sub groups of patients with LDH (n=67) and LDHD (n=37) in comparison to control subjects. Pre-tested questionnaire was administered to all participants to gather information.Results & Discussion: Among the cases 35.6 % presented with LDHD while 64.4 % had only LDH. Among the socio-demographic characters, body mass index <25 kgm-2 was a significant protective factor for both LDHD (OR=0.31; 95% CI=0.13-0.72) and LDH (OR=0.39; 95% CI=0.20-0.77). Involvement in daily activities with heavy (OR=5.1; 95 % CI=2.1-11.8) and moderate strain (OR=3.1; 95 % CI=1.5-6.6) to back, sitting more than eight hours per day (OR=5.1; 95 % CI=1.0-25.7), smoking (OR=5.0; 95 % CI=1.5-16.4) and sleeping in supine position (OR=2.09; 95% CI=1.09-4.06) were significant risk factors for LDH. Only daily physical activities with heavy strain act as a significant risk factor (OR=3.1; 95 % CI=1.1-8.5) for the development of LDHD. Types of mattresses used did not have a significant difference among cases and controls. Majority of cases (56.7 %) did not know the causative factor that led to LDH. According to the regression model, BMI, smoking and involvement in physical activities with moderate and heavy strain to back were considered as significant risk factors for the development of LDH or LDHD.Conclusion: In regression model BMI, smoking and daily physical activities with moderate and heavy strain to back were found to be the significant risk factors for development of LDH or LDHD.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 424-434

2020 ◽  
Author(s):  
Niroshima Withanage ◽  
Sunil Perera ◽  
Hemantha Peiris ◽  
Sharmini Prathapan ◽  
Lohini athiththan

Abstract Background: Although many studies have been conducted on risk factors associated with lumbar disc herniation (LDH), only few studies reported on the association of these factors in comparison to LDH and lumbar disc herniation and degeneration (LDHD). There are no reported studies on a regression model incorporating these factors. As the risk factors are better described in regression models, present study aimed to develop a regression model associated with LDH and LDHD in relation to socio-demographic, behavioural and occupational factors.Methods: A case control study conducted using 104 cases with LDH and controls (n=104) without LDH. Pre-tested questionnaire was administered to all participants to gather information.Results: Among the cases with LDH, 35.6 % presented with LDHD while 64.4 % had only LDH. Among the socio-demographic characteristics, body mass index <25 kgm-2 was a significant protective factor for both LDHD (OR=0.31; 95% CI=0.13-0.72) and LDH (OR=0.39; 95% CI=0.20-0.77). Involvement in daily activities with heavy (OR=5.1; 95 % CI=2.1-11.8) and moderate strain (OR=3.1; 95 % CI=1.5-6.6) to back, sitting more than eight hours per day (OR=5.1; 95 % CI=1.0-25.7), smoking (OR=5.0; 95 % CI=1.5-16.4) and sleeping in supine position (OR=2.09; 95% CI=1.09-4.06) were significant risk factors for LDH. Only daily physical activities with heavy strain act as a significant risk factor (OR=3.1; 95 % CI=1.1-8.5) for the development of LDHD. Types of mattresses used did not have significant difference among cases and controls. Majority of cases (56.7 %) did not know the causative factor that led to LDH. According to the regression model, BMI, smoking and involvement in physical activities with moderate and heavy strain to back were considered as significant risk factors for the development of LDH or LDHD.Conclusion: BMI, smoking and daily physical activities with moderate and heavy strain to back are significant risk factors for development of LDH or LDHD in regression model.


2018 ◽  
Vol 43 (4) ◽  
pp. 963-967 ◽  
Author(s):  
Eun-Ho Shin ◽  
Kyu-Jung Cho ◽  
Young-Tae Kim ◽  
Myung-Hoon Park

2016 ◽  
Vol 59 (2) ◽  
pp. 143 ◽  
Author(s):  
Jung Sik Bae ◽  
Kyung Hee Kang ◽  
Jeong Hyun Park ◽  
Jae Hyeon Lim ◽  
Il Tae Jang

2019 ◽  
Vol 103 (1-2) ◽  
pp. 87-94
Author(s):  
Qi Lai ◽  
Yuan Liu ◽  
Runsheng Guo ◽  
Xin Lv ◽  
Qiang Wang ◽  
...  

Purpose: To investigate the association of facet joint asymmetry with lumbar disc herniation at the lower lumbar spine. Methods: A total of 90 patients (ages 18–40 years) with single-level disc herniation (L3–L4, L4–L5, or L5–S1) were included in the study. Facet asymmetry was defined as a difference of 10° in facet joint angles between right and left sides. Normal discs in the same segment of other individuals were used as a control. Patients had facet asymmetry measured for L3 to S1 through 3.0T magnetic resonance imaging, and information was collected, including age, sex, degenerative degree of lumbar facet joints, and the presence or absence of lumbar disc herniation and type. Results: At the L3 to L4 level, 2 cases had facet asymmetry in 8 patients with lumbar disc herniation, compared with 17 cases of facet asymmetry in 82 patients without disc herniation (P = 0.7776, r = 0.030). At the L4 to L5 level, there were 21 cases of facet asymmetry in 45 patients with lumbar disc herniation, compared with 5 cases of asymmetry in 45 patients without disc herniation (P = 0.00019, r = 0.392). At the L5 to S1 level, there were 25 cases of facet asymmetry in 37 patients with lumbar disc herniation, compared with 11 cases of facet asymmetry in 53 patients without disc herniation (P = 0.0000, r = 0.492). There were 23 cases of facet asymmetry in 28 disc herniations of side type compared with 2 cases of facet asymmetry in 9 herniations of center type (P = 0.0008, r = 0.364). There was no significant difference in the relationship between age, facet joint degeneration, and lumbar facet joint asymmetry (P &gt; 0.05). Conclusion: Facet asymmetry is significantly associated with lumbar disc herniation at the L4 to L5 and the L5 to S1 levels, whereas there is an obvious association with the side type of lumbar disc herniation at the L5 to S1 level.


2019 ◽  
Author(s):  
Feilong Wei ◽  
Haoran Gao ◽  
Yifang Yuan ◽  
Shu Qian ◽  
Quanyou Guo ◽  
...  

Abstract Background: Percutaneous Transforaminal Endoscopic Discectomy is used increasingly in patients with Lumbar Disc Herniation. There is little knowledge on the related factors including SLR test influencing the operation. Therefore, we designed this prospective study to explore the relevant factors influencing postoperative effect of PTED surgery.Methods: Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and received PTED surgery. 4 kinds of scales including VAS (lumbar/leg), ODI and JOA were measured and reassessed at 1 day, 3 months, 6 months, 12months and 36 months after the PTED to assess their surgical outcomes. Results: All the patients had successful surgery. ODI and VAS (lumbar/leg) decreased in all patients and groups. And there was a statistically significant difference in each postoperative follow-up compared with that before surgery in every visit. In addition, the increase of JOA in postoperation was statistically significant compared with that before surgery. And, there is statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°-) in the changes of the scores of VAS(leg), ODI and JOA. However, there is no statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°--RRB- in the changes of the score of VAS(lumbar). Conclusions: PTED showed great effect on treating patients with lumbar disc herniation. And the main scale score such as VAS(leg). ODI and JOA showed that there is a statistically significant difference between the three subpopulations treated by PTED. Patients with SLR negative may get greater benefit from PTED.


2016 ◽  
Vol 24 (4) ◽  
pp. 592-601 ◽  
Author(s):  
Shota Takenaka ◽  
Kosuke Tateishi ◽  
Noboru Hosono ◽  
Yoshihiro Mukai ◽  
Takeshi Fuji

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.


2018 ◽  
Vol 4 (1) ◽  
pp. 55-59
Author(s):  
Tashi Wangchuk ◽  
Kunzang P. Wangmo ◽  
Thinley Norbu

Introduction: Low back pain is one of the most common complaints in the general population which represents a significant public health problem. Epidural Steroid Injection is being considered as a simple, effective and minimally invasive treatment modality for lumbar disc herniation. However, most studies only find a short-term benefit. In Bhutan, till date, no study has been done in Bhutan on this subject. The objective of our study was to find the effect of epidural steroid injection for low back pain due to lumbar disc herniation. Methods: An observational one-year-period study completed in Jigme Dorji Wangchuck National Referral Hospital. Symptomatic and positive Magnetic Resonance Imaging patients with lumbar disc herniation were included in our study. Pain scores were collected using Numeric Rating Scale at three different points of study. We also included patients’ age, weight and trauma history as some of the independent variables to study their associations with pain scores. The data obtained were analyzed using the Stata software program. One way repeated measures ANOVA was used to assess the significant difference in pain score. Results: Out of 100 participants recruited for the study, 91 of them completed demographic data and only 81 patients completed follow-up till 4 weeks post-treatment for demographic analysis and analytical analysis, respectively. There was a significant difference in pain scores in all three different points of study (p <0.01). No significant difference was observed in the pain scores amongst different age groups, gender, occupation and trauma history (p >0.05) at all three points of study. Conclusion: Our study observed a significant short-term benefit from epidural Triamcinolone injection for symptomatic lumbar disc herniation.


2020 ◽  
Author(s):  
Sherwan Hamawandi ◽  
Injam Ibrahim Sulaiman ◽  
Ameer Kadhim Al-Humairi

Abstract Background Discectomy for symptomatic lumbar disc herniation is the most common surgical procedure in spine surgery. Lumbar discectomy can be done by traditional open method or by varieties of minimal invasive techniques mainly microscopic or endoscopic procedures. This study evaluates the effectiveness of microdiscectomy compared with open discectomy in the treatment of lumbar disc herniation as a relation to the relief of leg pain, post-operative back pain, postoperative hospital stay and returns to daily activity. Methods Sixty patients were included in this study, 30 patients underwent an open discectomy and 30 patients underwent microdiscectomy. Those patients were followed up for 12 months after surgery. Each patient was evaluated for the postoperative back pain, leg pain, duration of hospital stay postoperatively and return to sedentary daily activity. The methods used to evaluate each patient are Visual analogue scale for back pain and leg pain and Oswestry disability index. Results Results showed that there is a significant difference in the postoperative back pain, duration of postoperative hospital stay and the time of return to sedentary daily activities between open discectomy and microdiscectomy with superiority for microdiscectomy while there is no significant difference in the relieving leg pain between the open discectomy and microdiscectomy. Conclusion Microdisctomy is effective as open discectomy in the aspect of relieving the leg pain with the advantage of less postoperative back pain, less postoperative hospital stay and early return to sedentary daily activities.


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