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Risk Factors for Lumbar Intervertebral Disc Herniation in Chinese Population: A Case-Control Study

Zhang, Yin-gang, MD, PhD*; Sun, Zhengming, MD*; Zhang, Zhi, MD*; Liu, Jian, MD; Guo, Xiong, MD

doi: 10.1097/BRS.0b013e3181a3c2de
Clinical Case Series
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Study Design. A case-control study of 4180 subjects was carried.

Objective. To explore the risk factors of lumbar disc herniation in China.

Summary of Background Data. In China, along with the economic development, people’s living environment and working conditions have undergone some tremendous changes, such as the accelerating life pace and competition. In this situation, it is important to know whether the risk factors of lumbar disc herniation have changed or not. This case-control study, including the possible social and psychological factors based on the literature, attempted to search the new risk factor, therefore provide better prevention measures for lumbar disc herniation.

Methods. A total of 2010 hospitalized patients, diagnosed with lumbar disc protrusion by CT and/or MRI were selected as cases. A total of 2070 people from communities and hospitals, without history of low back pain and sciatica, were selected as controls. All patients and controls were investigated for their family history, occupational characters’ smoking status, working psychosocial factors, etc. The risk factors were analyzed by multiple nonconditional logistic regression method.

Results. Family history (OR = 3.6) was the most important risk factor for lumbar disc protrusion in this study, followed by lumbar load (OR = 2.1), hard-working (OR = 1.8), and time urgency (OR = 1.1). Additionally, physical exercises (OR = 0.5) and bed characteristics (OR = 0.4) appeared to be the protective factors for lumbar disc protrusion. After stratified by age, family history (OR = 14.5), occupational character (OR = 5.2), and physical exercises (OR = 0.2) stronger association with lumbar disc protrusion was seen in subjects younger than 30 years. In subjects from 30 to 55 years, family history (OR = 5.1), lumbar load (OR = 1.91), hard-working (1.9), physical exercises (OR = 0.5), time urgency (OR = 1. 3), bed characteristics (OR = 0.4) were significantly important. In subjects older than 55 years, lumbar load (OR = 2.9) and bed characteristics (OR = 0.4) were closely related to lumbar disc protrusion.

Conclusion. Family history, lumbar load, hard-working, and time urgency are the major risk factors for lumbar disc herniation, and physical exercises and sleeping on the hard bed might be the protective factors.

A case-control study of 4180 subjects is to explore the risk factors of lumbar disc herniation in China. The results show family history, lumbar load, hard-working, and time urgency are the major risk factors and physical exercises and sleeping on the hard bed might be the protective factors.

From the *Department of Orthopaedics, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Shanxi, People’s Republic of China; †Department of Spinal Surgery, Tangcheng Hospiatal, Tainan, Taiwan, People’s Republic of China; and ‡Key Laboratory of Environment and Genes Related to Disease of Education Ministry, Medical College of Xi’an Jiaotong University, Xi’an, Shanxi, People’s Republic of China.

Acknowledgment date: October 11, 2008. Revision date: December 25, 2008. Acceptance date: March 4, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Other funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by The Clinical Researched Fund of First Affiliated Hospital of Medical College of Xi’an Jiaotong University.

Address correspondence and reprint requests to Yin-gang Zhang, MD, PhD, Department of Orthopaedics of the First Affiliated Hospital, Medical College of Jiaotong University, Xi’an 710061, People’s Republic of China; E-mail: zyingang@mail.xjtu.edu.cn

© 2009 Lippincott Williams & Wilkins, Inc.