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Chiropractic Research Review

Environmental Risk Factors for Disc Degeneration

Mechanical stress on the spine is considered to accelerate and increase the odds for disc herniation. Few long-term studies involving magnetic resonance imaging (MRI) consider multiple risk factors for disc degeneration, such as clinical; physical; psychosocial; occupational; and

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morphologic factors, and the link between low back pain (LBP) and disc degeneration.

This study investigated multiple predictors for disc deterioration, and a possible link between degeneration and LBP. Forty-one 20- to 50-year-old subjects provided data on sociodemographics; psychosocial factors; sports participation; pain; and occupation. MRI was used at baseline and five years later on the same imaging device to determine disc degeneration and abnormalities. Two experienced musculoskeletal radiologists evaluated MRIs; matched controls were used for comparison.

Forty-one percent of the subjects developed disc degeneration over the five-year period, with over half of these showing degeneration of one grade or more. The relationship between disc degeneration and LBP for this group of people was not statistically significant. The factors significantly linked to disc degeneration in this study were:

* night shift work, which increased the risk by 23 times, compared to the control group;
* initial disc degeneration at baseline, which increased the risk 13 times; and
* lack of sports participation, which increased the risk nearly three times.

No other factors were significant predictors of disc degeneration. The authors suggest that occupational factors may have been overestimated as a cause for disc degeneration and that environmental and individual psychological factors should also be considered. Ultimately, lack of sports participation, night shift work, and initial disc degeneration were found to be significant risk factors for disc degeneration.

Elfering A, Semmer N, Birkhofer D, et al. Young Investigator Award 2001 Winner: Risk factors for lumbar disc degeneration: A 5-year prospective MRI study in asymptomatic individuals. Spine 2002:27(2), pp. 125-134.

Chiropractic Research Review

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