Lumbar disc
degeneration (LDD) is commonly occurring degenerative musculoskeletal diseases.
Despite many efforts, the specific factors responsible for LDD remain unclear.
Various environmental factors, such as occupation have been implicated in the etiology
and pathogenesis of LDD. Therefore,
Physical workplace factors seem to play an important etiological role.
The current study
is designed as multicenter, population-based, case-control study aimed to
evaluate the potential differences in the “occupational risk profiles” of
structural lumbar disc diseases and low back pain (LBP).
The study
enrolled a total of 901 patients with structural lumbar disc diseases (disc
herniation or severe disc space narrowing) and 233 were recruited as control
subjects with “LBP”. Both groups were then compared with 422 control subjects
who were free of LBP. All other criteria like case history, pain data,
neurological deficits and movement restrictions were documented. The Nordic
questionnaire was used to record LBP on musculoskeletal symptoms. An
independent study radiologist was involved in inspecting about all MRI, CT and
X-rays. The calculation of cumulative physical workload was based on a
computer-assisted interview and a biomechanical analysis by the 3-D-dynamic
simulation tool. Documentation of occupational exposures for the whole working
life was also done.
The outcomes of
the study found a positive dose-response relationship between cumulative lumbar
load and LBP among men, but not women. The risk of physical occupation was
found to be higher for structural lumbar disc diseases (OR 3.7; CI 2.3–6.0) as
compared to low back pain (OR 1.9; 95% CI 1.0–3.5).
Overall, the
finding of the study estimated potentially different etiological pathways in
the heterogeneous disease group of LBPs. Results indicated that every
structural disc damage that arises from the physical workload, not always leads
to LBP.
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