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Shim GY, Choi J, Kim HJ, Kwon R, Kim MS, Yoo MC, Rahmati M, Cho W, Yon DK. Global, Regional, and National Burden of Spine Pain, 1990-2019: A Systematic Analysis of the Global Burden of Disease Study 2019. Arch Phys Med Rehabil 2024; 105:461-469. [PMID: 37956823 DOI: 10.1016/j.apmr.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To describe the global, regional, national, and temporal trends in neck pain (NP) and low back pain (LBP) from 1990 to 2019 and analyze associations with age, sex, and sociodemographic index (SDI). DESIGN Temporal trends analyses of the Global Burden of Disease 2019 data for global, regional, and national prevalence, incidence, and years lived with disabilities (YLDs) of NP and LBP from 1990 to 2019. SETTING Not applicable. PARTICIPANTS Not applicable. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) The temporal trends in prevalence, incidence, and YLDs of NP and LBP, and associations with age, sex, and SDI. RESULTS Globally, the prevalence, incidence, and YLDs of NP and LBP significantly increased; however, the age-standardized rates of NP showed a stable trend, and those of LBP slightly decreased from 1990 to 2019. The burden of NP and LBP was higher in women than in men. Both NP and LBP exhibited similar age-related trends, with the total numbers and rates increasing with age and reaching their highest points in the middle- and old-aged groups, respectively, in 2019. Overall, the prevalence, incidence, and YLDs of NP and LBP were higher in regions with higher SDI over the 3 decades. CONCLUSIONS NP and LBP impose significant major public health burden globally. Although both conditions are more frequent in women and middle-aged groups and tend to be prevalent in countries with high SDI, they have distinct temporal and regional patterns. By comprehending temporospatial trends in the disease burden of NP and LBP, policymakers and health care professionals can make future interventions and policies to effectively manage these conditions worldwide as well as to achieve equity in prevention, diagnosis, and treatment.
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Affiliation(s)
- Ga Yang Shim
- Department of Physical and Rehabilitation Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Jungwoo Choi
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Min Seo Kim
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Myung Chul Yoo
- Department of Physical and Rehabilitation Medicine, Kyung Hee University Hospital, Seoul, South Korea
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Wonyoung Cho
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea; Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea.
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Chen L, Zhong Y, Sun S, Yang Z, Hong H, Zou D, Song C, Li W, Leng H. HTRA1 from OVX rat osteoclasts causes detrimental effects on endplate chondrocytes through NF-κB. Heliyon 2023; 9:e17595. [PMID: 37416639 PMCID: PMC10320255 DOI: 10.1016/j.heliyon.2023.e17595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023] Open
Abstract
Endplate osteochondritis is considered one of the major causes of intervertebral disc degeneration (IVDD) and low back pain. Menopausal women have a higher rate of endplate cartilage degeneration than similarly aged men, but the related mechanisms are still unclear. Subchondral bone changes, mainly mediated by osteoblasts and osteoclasts, are considered an important reason for the degeneration of cartilage. This work explored the role of osteoclasts in endplate cartilage degeneration, as well as its underlying mechanisms. A rat ovariectomy (OVX) model was used to induce estrogen deficiency. Our experiments indicated that OVX significantly promoted osteoclastogenesis and anabolism and catabolism changes in endplate chondrocytes. OVX osteoclasts cause an imbalance between anabolism and catabolism in endplate chondrocytes, as shown by a decrease in anabolic markers such as Aggrecan and Collagen II, and an increase in catabolic markers such as a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5) and matrix metalloproteinases (MMP13). Osteoclasts were also confirmed in this study to be able to secrete HtrA serine peptidase 1 (HTRA1), which resulted in increased catabolism in endplate chondrocytes through the NF-κB pathway under estrogen deficiency. This study demonstrated the involvement and mechanism of osteoclasts in the anabolism and catabolism changes of endplate cartilage under estrogen deficiency, and proposed a new strategy for the treatment of endplate osteochondritis and IVDD by targeting HTRA1.
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Affiliation(s)
- Longting Chen
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
| | - Yiming Zhong
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
| | - Shang Sun
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
| | - Zihuan Yang
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
| | - Haofeng Hong
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
| | - Da Zou
- Engineering Research Center of Bone and Joint Precision Medicine, Beijing, 100191, China
| | - Chunli Song
- Beijing Key Lab of Spine Diseases, Beijing, 100191, China
| | - Weishi Li
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
| | - Huijie Leng
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China
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Najafi F, Darbandi M, Neya SK, Belasi MT, Izadi N, Pasdar Y, Barzegar A. Epidemiology of musculoskeletal disorders among iranian adults: results from a non-communicable disease cohort study. BMC Musculoskelet Disord 2023; 24:315. [PMID: 37087508 PMCID: PMC10122330 DOI: 10.1186/s12891-023-06435-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/16/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Persistent pain and reduced mobility and dexterity are the typical characteristics of Musculoskeletal disorders (MSDs). We aimed to determine the prevalence of back and joint pain, back, and joint stiffness, arthritis, and osteoporosis among adults and their distribution according to sociodemographic characteristics and comorbidities. METHODS This cross-sectional study was conducted on 9,520 participants aged 35-65 years from baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study, in the west of Iran. MSDs were evaluated by the RaNCD cohort study physician using a standard questionnaire. Binary logistic regression was used to determine associations and reported by odds ratios (OR) and 95% confidence intervals (CI). RESULTS The MSDs in women were significantly more than in men (59.06% vs. 40.94%, P < 0.001). Skeletal muscle mass (SMM) was significantly lower in subjects with MSDs, and waist circumference (WC) and visceral fat area (VFA) were higher than in the non-MSDs (P < 0.001). MSDs were significantly more common in urban men and women (OR = 1.33; 95% CI: 1.14-1.50 and OR = 1.59; 95% CI: 1.39-1.82, respectively). Obesity increased the odds of MSDs in women (OR = 1.57; 95% CI: 1.33-1.84), whereas there was no association between BMI and MSDs in men. Men with high socioeconomic status (SES) had lower odds of MSDs than men with weak SES (OR = 0.77; 95% CI: 0.64-0.92). CONCLUSION The MSDs were more prevalent among older people, women, obese people and urban dwellers. Lifestyle modification, especially weight loss may be helpful in reducing and controlling MSDs.
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Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sepideh Kazemi Neya
- Research Centre for Prevention of cardiovascular disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Tokazebani Belasi
- Research Centre for Prevention of cardiovascular disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akbar Barzegar
- Department of Occupational Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Gulati M, Dursun E, Vincent K, Watt FE. The influence of sex hormones on musculoskeletal pain and osteoarthritis. THE LANCET. RHEUMATOLOGY 2023; 5:e225-e238. [PMID: 38251525 DOI: 10.1016/s2665-9913(23)00060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 03/22/2023]
Abstract
The association of female sex with certain rheumatic symptoms and diseases is now indisputable. Some of the most striking examples of this association occur in individuals with musculoskeletal pain and osteoarthritis, in whom sex-dependent changes in incidence and prevalence of disease are seen throughout the lifecourse. Joint and muscle pain are some of the most common symptoms of menopause, and there is increasingly compelling evidence that changes in or loss of sex hormones (be it natural, autoimmune, pharmacological, or surgical) influence musculoskeletal pain propensity and perhaps disease. However, the effects of modulation or replacement of sex hormones in this context are far less established, particularly whether these approaches could represent a preventative or therapeutic opportunity once symptoms have developed. In this Review, we present evidence for the association of changes in sex hormones with musculoskeletal pain and painful osteoarthritis, discussing data from diverse natural, therapeutic, and experimental settings in humans and relevant animal models relating to hormone loss or replacement and the consequent effects on health, pain, and disease. We also postulate mechanisms by which sex hormones could mediate these effects. Further research is needed; however, increased scientific understanding of this complex area could lead to real benefits in musculoskeletal and women's health.
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Affiliation(s)
- Malvika Gulati
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Eren Dursun
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Katy Vincent
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Fiona E Watt
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK; Rheumatology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
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Alini M, Diwan AD, Erwin WM, Little CB, Melrose J. An update on animal models of intervertebral disc degeneration and low back pain: Exploring the potential of artificial intelligence to improve research analysis and development of prospective therapeutics. JOR Spine 2023; 6:e1230. [PMID: 36994457 PMCID: PMC10041392 DOI: 10.1002/jsp2.1230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/31/2022] [Accepted: 09/11/2022] [Indexed: 02/03/2023] Open
Abstract
Animal models have been invaluable in the identification of molecular events occurring in and contributing to intervertebral disc (IVD) degeneration and important therapeutic targets have been identified. Some outstanding animal models (murine, ovine, chondrodystrophoid canine) have been identified with their own strengths and weaknesses. The llama/alpaca, horse and kangaroo have emerged as new large species for IVD studies, and only time will tell if they will surpass the utility of existing models. The complexity of IVD degeneration poses difficulties in the selection of the most appropriate molecular target of many potential candidates, to focus on in the formulation of strategies to effect disc repair and regeneration. It may well be that many therapeutic objectives should be targeted simultaneously to effect a favorable outcome in human IVD degeneration. Use of animal models in isolation will not allow resolution of this complex issue and a paradigm shift and adoption of new methodologies is required to provide the next step forward in the determination of an effective repairative strategy for the IVD. AI has improved the accuracy and assessment of spinal imaging supporting clinical diagnostics and research efforts to better understand IVD degeneration and its treatment. Implementation of AI in the evaluation of histology data has improved the usefulness of a popular murine IVD model and could also be used in an ovine histopathological grading scheme that has been used to quantify degenerative IVD changes and stem cell mediated regeneration. These models are also attractive candidates for the evaluation of novel anti-oxidant compounds that counter inflammatory conditions in degenerate IVDs and promote IVD regeneration. Some of these compounds also have pain-relieving properties. AI has facilitated development of facial recognition pain assessment in animal IVD models offering the possibility of correlating the potential pain alleviating properties of some of these compounds with IVD regeneration.
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Affiliation(s)
- Mauro Alini
- AO Research Institute Davos Platz Switzerland
| | - Ashish D. Diwan
- Spine Service, Department of Orthopedic Surgery, St. George & Sutherland Campus, Clinical School University of New South Wales Sydney New South Wales Australia
| | - W. Mark Erwin
- Department of Surgery University of Toronto Ontario Canada
| | - Chirstopher B. Little
- Raymond Purves Bone and Joint Research Laboratory Kolling Institute, Sydney University Faculty of Medicine and Health, Northern Sydney Area Health District, Royal North Shore Hospital St. Leonards New South Wales Australia
| | - James Melrose
- Raymond Purves Bone and Joint Research Laboratory Kolling Institute, Sydney University Faculty of Medicine and Health, Northern Sydney Area Health District, Royal North Shore Hospital St. Leonards New South Wales Australia
- Graduate School of Biomedical Engineering The University of New South Wales Sydney New South Wales Australia
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Hart DA. Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle? Front Physiol 2023; 14:1127689. [PMID: 37113695 PMCID: PMC10126777 DOI: 10.3389/fphys.2023.1127689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be "imprinted" in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.
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Diwan AD, Melrose J. Intervertebral disc degeneration and how it leads to low back pain. JOR Spine 2022; 6:e1231. [PMID: 36994466 PMCID: PMC10041390 DOI: 10.1002/jsp2.1231] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 09/23/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this review was to evaluate data generated by animal models of intervertebral disc (IVD) degeneration published in the last decade and show how this has made invaluable contributions to the identification of molecular events occurring in and contributing to pain generation. IVD degeneration and associated spinal pain is a complex multifactorial process, its complexity poses difficulties in the selection of the most appropriate therapeutic target to focus on of many potential candidates in the formulation of strategies to alleviate pain perception and to effect disc repair and regeneration and the prevention of associated neuropathic and nociceptive pain. Nerve ingrowth and increased numbers of nociceptors and mechanoreceptors in the degenerate IVD are mechanically stimulated in the biomechanically incompetent abnormally loaded degenerate IVD leading to increased generation of low back pain. Maintenance of a healthy IVD is, thus, an important preventative measure that warrants further investigation to preclude the generation of low back pain. Recent studies with growth and differentiation factor 6 in IVD puncture and multi-level IVD degeneration models and a rat xenograft radiculopathy pain model have shown it has considerable potential in the prevention of further deterioration in degenerate IVDs, has regenerative properties that promote recovery of normal IVD architectural functional organization and inhibits the generation of inflammatory mediators that lead to disc degeneration and the generation of low back pain. Human clinical trials are warranted and eagerly anticipated with this compound to assess its efficacy in the treatment of IVD degeneration and the prevention of the generation of low back pain.
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Affiliation(s)
- Ashish D. Diwan
- Spine Service, Department of Orthopaedic Surgery, St. George & Sutherland Clinical School University of New South Wales Sydney New South Wales Australia
| | - James Melrose
- Raymond Purves Bone and Joint Research Laboratory Kolling Institute, Sydney University Faculty of Medicine and Health, Northern Sydney Area Health District, Royal North Shore Hospital Sydney New South Wales Australia
- Graduate School of Biomedical Engineering The University of New South Wales Sydney New South Wales Australia
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Shin DW, Shin JI, Koyanagi A, Jacob L, Smith L, Lee H, Chang Y, Song TJ. Global, regional, and national neck pain burden in the general population, 1990–2019: An analysis of the global burden of disease study 2019. Front Neurol 2022; 13:955367. [PMID: 36119688 PMCID: PMC9477009 DOI: 10.3389/fneur.2022.955367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background This study describes the global epidemiology and trends associated with neck pain. Global Burden of Disease data collected between 1990 and 2019 were used to determine the global burden of neck pain in the general populations of 204 countries. Methods Global, regional, and national burdens of neck pain determined by prevalence, incidence, and years lived with a disability (YLD) from 1990 to 2019 were comprehensively analyzed according to age, gender, and socio-demographic index using the Global Burden of Disease Study 1990 and 2019 data provided by the Institute for Health Metrics and Evaluation. Results Globally, in 2019, the age-standardized rates for prevalence, incidence, and YLD of neck pain per 100,000 population was 2,696.5 (95% uncertainty interval [UI], 2,177.0 to 3,375.2), 579.1 (95% UI, 457.9 to 729.6), and 267.4 (95% UI, 175.5 to 383.5) per 100,000 population, respectively. Overall, there was no significant difference in prevalence, incidence, or YLD of neck pain between 1990 and 2019. The highest age-standardized YLD of neck pain per 100,000 population in 2019 was observed in high-income North America (479.1, 95% UI 323.0 to 677.6), Southeast Asia (416.1, 95% UI 273.7 to 596.5), and East Asia (356.4, 95% UI 233.2 to 513.2). High-income North America (17.0, 95% UI 9.0 to 25.4%) had the largest increases in YLD of neck pain per 100,000 population from 1990 to 2019. At the national level, the highest age-standardized YLD of neck pain was found in the Philippines (530.1, 95% UI 350.6 to 764.8) and the highest change age-standardized YLD between 1990 and 2019 was found in the United States (18.4, 95% UI 9.9 to 27.6%). Overall, the global burden of neck pain increased with age until the age of 70–74 years, and was higher in women than men. In general, positive associations between socio-demographic index and burden of neck pain were found. Conclusions Because neck pain is a major public health burden with a high prevalence, incidence, and YLD worldwide, it is important to update its epidemiological data and trends to cope with the future burden of neck pain.
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Affiliation(s)
- Dong Woo Shin
- Department of Neurology, Mokdong Hospital Ewha Woman's University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Barcelona, Spain
- Institución Catalana de Investigación y Estudios Avanzados (ICREA), Barcelona, Spain
| | - Louis Jacob
- Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Barcelona, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance, and Well-Being, Anglia Ruskin University, Cambridge, United Kingdom
| | - Heajung Lee
- Department of Neurology, Seoul Hospital Ewha Woman's University College of Medicine, Seoul, South Korea
| | - Yoonkyung Chang
- Department of Neurology, Mokdong Hospital Ewha Woman's University College of Medicine, Seoul, South Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital Ewha Woman's University College of Medicine, Seoul, South Korea
- *Correspondence: Tae-Jin Song
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Palmer D, Cooper D, Whittaker JL, Emery C, Batt ME, Engebretsen L, Schamasch P, Shroff M, Soligard T, Steffen K, Budgett R. Prevalence of and factors associated with osteoarthritis and pain in retired Olympians compared with the general population: part 2 - the spine and upper limb. Br J Sports Med 2022; 56:bjsports-2021-104978. [PMID: 35961762 DOI: 10.1136/bjsports-2021-104978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES (1) To determine the prevalence of spine and upper limb osteoarthritis (OA) and pain in retired Olympians; (2) identify risk factors associated with their occurrence and (3) compare with a sample of the general population. METHODS 3357 retired Olympians (44.7 years) and 1735 general population controls (40.5 years) completed a cross-sectional survey. The survey captured demographics, general health, self-reported physician-diagnosed OA, current joint/region pain and significant injury (lasting ≥1 month). Adjusted ORs (aORs) compared retired Olympians and the general population. RESULTS Overall, 40% of retired Olympians reported experiencing current joint pain. The prevalence of lumbar spine pain was 19.3% and shoulder pain 7.4%, with lumbar spine and shoulder OA 5.7% and 2.4%, respectively. Injury was associated with increased odds (aOR, 95% CI) of OA and pain at the lumbar spine (OA=5.59, 4.01 to 7.78; pain=4.90, 3.97 to 6.05), cervical spine (OA=17.83, 1.02 to 31.14; pain=9.41, 6.32 to 14.01) and shoulder (OA=4.91, 3.03 to 7.96; pain=6.04, 4.55 to 8.03) in retired Olympians. While the odds of OA did not differ between Olympians and the general population, the odds of lumbar spine pain (1.44, 1.20 to 1.73), the odds of shoulder OA after prior shoulder injury (2.64, 1.01 to 6.90) and the odds of cervical spine OA in female Olympians (2.02, 1.06 to 3.87) were all higher for Olympians compared with controls. CONCLUSIONS One in five retired Olympians reported experiencing current lumbar spine pain. Injury was associated with lumbar spine, cervical spine and shoulder OA and pain for Olympians. Although overall OA odds did not differ, after adjustment for recognised risk factors, Olympians were more likely to have lumbar spine pain and shoulder OA after shoulder injury, than the general population.
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Affiliation(s)
- Debbie Palmer
- Edinburgh Sports Medicine Research Network, Institute for Sport PE and Health Sciences, The University of Edinburgh, Edinburgh, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Dale Cooper
- School of Allied Health Professions, Keele University, Keele, UK
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Centre Of Canada, Richmond, British Columbia, Canada
| | - Carolyn Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology and Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mark E Batt
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Queen's Medical Centre, Nottingham, UK
| | - Lars Engebretsen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Patrick Schamasch
- Medical Committee, World Olympians Association, Lausanne, Switzerland
| | - Malav Shroff
- Medical Committee, World Olympians Association, Lausanne, Switzerland
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Kathrin Steffen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
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Wei J, Chen L, Huang S, Li Y, Zheng J, Cheng Z, Xie Z. Time Trends in the Incidence of Spinal Pain in China, 1990 to 2019 and Its Prediction to 2030: The Global Burden of Disease Study 2019. Pain Ther 2022; 11:1245-1266. [PMID: 35969366 PMCID: PMC9633916 DOI: 10.1007/s40122-022-00422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With increasing life expectancy in China, the associated burden of low back and neck pain (spinal pain) on the healthcare system increases, posing a substantial public health challenge. This study aimed to investigate trends in spinal pain incidence across China from 1990 to 2019 and to predict incidence trends between 2020 and 2030. METHODS Data were derived from the Global Burden of Disease Study (GBD) 2019. The annual percentage change (APC) and average annual percentage change (AAPC) between 1990 and 2019 were calculated using Joinpoint regression analysis. The effects of age, period, and cohort on spinal pain were estimated by an age-period-cohort model. An autoregressive integrated moving average (ARIMA) model was used to forecast incidence trends from 2020 to 2030. RESULTS From 1990 to 2019, the age-standardized incidence rate (ASIR) of low back pain (LBP) significantly decreased in both male and female subjects, while the ASIR of neck pain (NP) slightly increased regardless of sex. Joinpoint regression analysis showed that the incidence rates of LBP decreased in all age groups, and incidence rates of NP increased after 45 years old among men and women. The age effects showed that the relative risks (RR) of LBP incidence increased with age, and the group aged 40-49 years had the highest RR for NP incidence, regardless of sex. Period effects showed that the risk of NP continuously increased with increasing time periods, but not in LBP. The cohort effect showed a continuously decreasing trend in later birth cohorts. The prediction results of the ARIMA model show that the ASIR of NP in both male and female subjects in China shows an increasing trend in the next 10 years, and the ASIR of LBP increased in male but decreased in female subjects. CONCLUSION Spinal pain has remained a major public health burden over the past 30 years in China and will likely increase further with population aging. Therefore, spinal pain should be a priority for future research on prevention and therapy, and is especially critical as the aging population increases in China.
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Affiliation(s)
- Jiehua Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Shengbin Huang
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Ying Li
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Jingmao Zheng
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Zhilin Cheng
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China
| | - Zhaolin Xie
- Department of Orthopedics, Guigang People's Hospital, Guigang, 537100, Guangxi, China.
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11
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Wáng YXJ, Deng M, Griffith JF, Kwok AWL, Leung JCS, Lam PMS, Yu BWM, Leung PC, Kwok TCY. 'Healthier Chinese spine': an update of osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong spine radiograph studies. Quant Imaging Med Surg 2022; 12:2090-2105. [PMID: 35284274 PMCID: PMC8899940 DOI: 10.21037/qims-2021-07] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/16/2021] [Indexed: 08/09/2023]
Abstract
For the MrOS (Hong Kong) and MsOS (Hong Kong) baseline (BL) studies, community-dwelling 2,000 Chinese men (mean age: 72.3 years) and 2,000 Chinese women (mean age: 72.5 years) were recruited from 2001 to 2003. These two studies have spanned two decades till now. This review summarizes our spine radiograph results. Senile and post-menopausal osteoporosis were associated with intervertebral disc volume reduction; and in women, menopause accelerates disc degeneration. Elderly women's osteoporotic vertebral fracture (OVF) prevalence was double of that of elderly men. For year-4 follow-up (FU), male participants with BL OVF had little increased risk for further OVF. In our study comparing OVF rates in age-matched Hong Kong Chinese women and Italian Caucasian women (mean age: 74.1 years), endplate and/or cortex fracture (ECF) prevalence was 26% for Chinese and 47% for Italian. OVF with ≥40% vertebral height loss was recorded among 9.5% of the Chinese subjects while among 26% of the Italian subjects. OVFs in Italian subjects were more likely to be multiple and generally severer. Clinical spine fractures were recorded 133 cases/100,000 person-years in MrOS (Hong Kong) participants and 273 cases/100,000 person-years in MsOS (Hong Kong) participants. Literature review suggests the clinical vertebral fracture rates among elderly Hong Kong Chinese subjects are approximately half of those of American, Australian, and Canadian subjects. Data synthesis suggests elderly Caucasians have a higher degenerative spondylolisthesis prevalence, being approximately 70% higher than that of elderly Hong Kong Chinese. Literature review of other authors' publications shows, compared with Caucasians, Chinese have a much lower incident rate of back pain. We conclude that elderly Chinese have a generally healthier spine relative to elderly Caucasians.
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Affiliation(s)
- Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Min Deng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - James F. Griffith
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Anthony W. L. Kwok
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China
| | - Jason C. S. Leung
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patti M. S. Lam
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Blanche Wai Man Yu
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ping Chung Leung
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Timothy C. Y. Kwok
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Chen S, Chen M, Wu X, Lin S, Tao C, Cao H, Shao Z, Xiao G. Global, regional and national burden of low back pain 1990-2019: A systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat 2022; 32:49-58. [PMID: 34934626 PMCID: PMC8639804 DOI: 10.1016/j.jot.2021.07.005] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To comprehensively analyze the global level and trends of prevalence, incidence and years lived with disability (YLDs) for low back pain (LBP) from 1990 to 2019 by age, sex and sociodemographic index (SDI). METHODS Publicly available modelled data and methods were obtained from the Global Burden of Diseases (GBD) study 2019, and used to evaluate the global burden of LBP through a systematic analysis. RESULTS Globally, the age-standardized prevalence, incidence and YLDs rate of LBP were slightly decreased from 1990 to 2019, but the number of the prevalent cases, incident cases and YLDs had substantially increased, and LBP remains the leading cause of YLDs in 2019 worldwide. The number of prevalent cases was increased with age and peaked at the age of 45-54 years for both sexes, and the global prevalence rate was higher in females than in males and increased with age, peaking at the 80-84 age group in both sexes in 2019. Overall, a positive association between the age-standardized YLD rate and SDI was observed over the past thirty years. At the national revel, the United States, Denmark and Switzerland had the three highest levels of age-standardized prevalence, while Zambia, Zimbabwe and Canada showed the highest increase in the age-standardized prevalence during 1990-2019. CONCLUSIONS LBP is a major public health issue globally, and its burden remains high. Increasing population awareness about its risk factors and preventive measures for LBP are needed to reduce the future burden of this condition. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE Due to the high prevalence and heavy burden of LBP globally, it is important to update its epidemiological data. This systematic analysis provides researchers and healthcare policy makers with up-to-date, comprehensive and comparable information on global LBP burden, which is of clinical translational significance.
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Affiliation(s)
- Sheng Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Mingjue Chen
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Xiaohao Wu
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Sixiong Lin
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Chu Tao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Huiling Cao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Guozhi Xiao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, 518055, China
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13
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Prevalence and factors associated with low back pain in retired Great Britain’s Olympians: A cross‐sectional study. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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Li X, Xie Y, Lu R, Zhang Y, Li Q, Kober T, Hilbert T, Tao H, Chen S. Q-Dixon and GRAPPATINI T2 Mapping Parameters: A Whole Spinal Assessment of the Relationship Between Osteoporosis and Intervertebral Disc Degeneration. J Magn Reson Imaging 2021; 55:1536-1546. [PMID: 34664744 DOI: 10.1002/jmri.27959] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The relationship between osteoporosis and intervertebral disc (IVD) degeneration remains controversial. Novel quantitative Dixon (Q-Dixon) and GRAPPATINI T2 mapping techniques have shown potential for evaluating the biochemical components of the spine. PURPOSE To investigate the correlation of osteoporosis with IVD degeneration in postmenopausal women. STUDY TYPE Prospective. SUBJECTS A total of 105 postmenopausal females (mean age, 65 years; mean body mass index, 26 kg/m2 ). FIELD STRENGTH/SEQUENCE 3 T; sagittal; 6-echo Q-Dixon, multiecho spin-echo GRAPPATINI T2 mapping, turbo spin echo (TSE) T1-weighted and TSE T2-weighted sequences. ASSESSMENT The subjects were divided into normal (N = 47), osteopenia (N = 28), and osteoporosis (N = 30) groups according to quantitative computed tomography examination. The Pfirrmann grade of each IVD was obtained. Region of interest analysis was performed separately by two radiologists (X.L., with 10 years of experience, and S.C., with 20 years of experience) on a fat fraction map and T2 map to calculate the bone marrow fat fraction (BMFF) from the L1 to L5 vertebrae and the T2 values of each adjacent IVD separately. STATISTICAL TESTS One-way analysis of variance, post-hoc comparisons, and Kruskal-Wallis H tests were performed to evaluate the differences in the magnetic resonance imaging parameters between the groups. The relationships between BMFF and the IVD features were analyzed using the Spearman correlation analysis and linear regression models. RESULTS There were significant differences in BMFF among the three groups. The osteoporosis group had higher BMFF values (64.5 ± 5.9%). No significant correlation was found between BMFF and Pfirrmann grade (r = 0.251, P = 0.06). BMFF was significantly negatively correlated with the T2 of the adjacent IVD from L1 to L3 (r = -0.731; r = -0.637; r = -0.547), while significant weak correlations were found at the L4 to L5 levels (r = -0.337; r = -0.278). DATA CONCLUSION This study demonstrated that osteoporosis is associated with IVD degeneration. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Xiangwen Li
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuxue Xie
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Rong Lu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyang Zhang
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Qing Li
- MR Collaborations, Siemens Healthineers Ltd., Shanghai, China
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Tom Hilbert
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Hongyue Tao
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuang Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
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15
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Elderly men have much lower vertebral fracture risk than elderly women even at advanced age: the MrOS and MsOS (Hong Kong) year 14 follow-up radiology results. Arch Osteoporos 2020; 15:176. [PMID: 33159570 DOI: 10.1007/s11657-020-00845-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023]
Abstract
UNLABELLED MrOS MsOS (Hong Kong) studies year 14 follow-up shows for subjects without baseline osteoporotic vertebral deformity, women's incident vertebral fracture (VF) rate was twice that of men. For subjects with vertebral deformity of baseline ≥ 20% height loss, counting subject, women's incident VF rate was three times higher than that of men. INTRODUCTION For MrOS MsOS (Hong Kong) baseline (BL) studies, 2000 men and 2000 women ≥ 65 years were recruited during 2001 to 2003. This study presents the year 14 follow-up (FU). MATERIALS Whole spine MRI was performed in 271 males (mean, 82.8 ± 3.6 years) and 150 females (mean, 82.0 ± 4.29 years). Osteoporotic vertebral deformity (OVD) classification included no OVD (grade 0), and OVDs with < 20%, 20~25%, > 25%~1/3, > 1/3~40%, > 40%~2/3, and > 2/3 height loss (grade 1~6). With an existing VD, a further height loss of ≥ 15% was a VD progression. A new incident VD was a change from grade 0 to ≥ grade 2 or to grade 1 with ≥ 10% height loss. OVD progression and new incident OVD were considered incident VF. RESULTS The proportion of osteoporotic subjects only slightly increased during FU for men but doubled for women. Groupwise, OVD was not associated with back pain in men; but OVD with > 1/3 height loss was associated with back pain in women. For subjects without BL OVD, 7.9% of men and 14.6% of women had incident VF. For subjects with BL OVD of ≥ 20% height loss, men's and women's incident VF were 17.6% and 52.6%, respectively, counting subject and 1.68% and 7.89%, respectively, counting vertebra. CONCLUSION Elderly men with or without existing osteoporotic VD have much lower future VF risk than elderly women.
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Ji Y, Hong W, Liu M, Liang Y, Deng Y, Ma L. Intervertebral disc degeneration associated with vertebral marrow fat, assessed using quantitative magnetic resonance imaging. Skeletal Radiol 2020; 49:1753-1763. [PMID: 32468097 PMCID: PMC7497503 DOI: 10.1007/s00256-020-03419-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the potential clinical application of quantitative MRI in assessing the correlation between lumbar vertebrae bone marrow fat deposition and intervertebral disc degeneration. MATERIALS AND METHODS A total of 104 chronic lower-back pain volunteers underwent 3.0-T MRI with T2-weighted imaging, T2 mapping, and iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL-IQ) between August 2018 and June 2019. Each disc was assessed with T2 value by T2 mapping, and the L1-S1 vertebral bone marrow fat fraction was assessed by IDEAL-IQ. The differences and relationship between T2 value and the adjacent vertebral bone marrow fat fraction values within the five Pfirrmann groups, five age groups, and five lumbar levels were statistically analyzed. RESULTS The vertebral bone marrow fat fraction had a significant negative correlation with T2 values of nucleus pulposus' T2 values (p < 0.001). However, the significant negative correlation was only found between T2 values of nucleus pulposus and adjacent vertebral bone marrow fat in Pfirrmann II-III, L1/2-L5/S1 level, and 40-49 years' age groups. Pfirrmann grades of the intervertebral disc were positively correlated with adjacent vertebrae bone marrow fat fraction (p < 0.05). CONCLUSION Lumbar bone marrow fat deposition significantly increases during the early stages of intervertebral disc degeneration. Quantitative measurements of bone marrow fat deposition and water content of intervertebral discs have a predictive value and are an important supplement to the qualitative traditional classification strategies for the early stages of intervertebral disc degeneration.
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Affiliation(s)
- Yayun Ji
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou City, 510080 Guangdong Province China
| | - Weifeng Hong
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou City, 510080 Guangdong Province China
| | - Mouyuan Liu
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou City, 510080 Guangdong Province China
| | - Yuying Liang
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou City, 510080 Guangdong Province China
| | - YongYan Deng
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou City, 510080 Guangdong Province China
| | - Liheng Ma
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou City, 510080 Guangdong Province China
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Falkingham J, Evandrou M, Qin M, Vlachantoni A. Chinese women's health and wellbeing in middle life: Unpacking the influence of menopause, lifestyle activities and social participation. Maturitas 2020; 143:145-150. [PMID: 33308620 DOI: 10.1016/j.maturitas.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/12/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine Chinese middle-aged women's health and wellbeing and the associated biosocial correlates. STUDY DESIGN This study used a cross-sectional design, including selected retrospectively collected information on the final menstrual period, drawn from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS). Women aged 45 to 59 were selected. MAIN OUTCOME MEASURES Factor analysis of 16 menopausal symptom ratings yielded four different and independent measures of pre-/peri-menopausal and early postmenopausal women's health. These were: negative mood (feel frustrated, sad, lonely, worried, bored, angry, tired and stressed), positive emotions (feel enthusiastic, content and happy), musculoskeletal pain (shoulder/neck pain, knee and other joint pain, and back pain), and sleep and memory problems (trouble sleeping and poor memory). RESULTS Menopausal status was positively associated with sleep and memory problems, whilst the number of years since the final menstrual period was positively associated with musculoskeletal pain. In contrast, lifestyle activities and social participation were linked to positive emotions. The association between selected biosocial factors and negative mood was not significant after controlling for other demographic and social background factors. CONCLUSIONS Musculoskeletal health as well as sleep and memory problems are positively associated with menopausal biological factors amongst Chinese mid-life women. Maintaining active social engagement contributes to positive wellbeing among middle-aged women.
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Affiliation(s)
- Jane Falkingham
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Maria Evandrou
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK; Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK
| | - Min Qin
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK; Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK
| | - Athina Vlachantoni
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK; Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK
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Song XX, Jin LY, Li XF, Luo Y, Yu BW. Substance P Mediates Estrogen Modulation Proinflammatory Cytokines Release in Intervertebral Disc. Inflammation 2020; 44:506-517. [PMID: 32965648 DOI: 10.1007/s10753-020-01347-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
Abstract
Intervertebral disc degeneration (IDD) is a main contributor to low back pain. A close relationship exists between inflammation and pain. Estrogen can affect inflammation and may play a crucial role in IDD and pain. Substance P (SP) can also regulate the expression of pro-inflammatory cytokines in intervertebral disc (IVD). This study aimed to investigate the potential role of SP in estrogen regulation of IDD. Nine-week-old C57BL/6 female mice were divided into four groups as follows: sham surgery (sham), ovariectomy (OVX), ovariectomy plus estrogen replacement therapy (ERT) group (OVX+E2), and ovariectomy, ERT plus neurokinin 1 receptor (NK1R) agonist (OVX+E2+G). Serum E2, body, and uterus weight were recorded. Immunohistochemistry study and quantitative real-time PCR were used for SP, NK1R, IL-1β, IL-6, and TNF-α examination and comparison in IVD at protein and gene levels. After OVX, the gene and protein expression of TNF-α, IL-1β, IL-6, SP, and NK1R in NP cells significantly increased compared with the sham group. ERT can reverse these impacts. ERT plays anti-inflammatory and anti-hyperalgesic roles in IDD of OVX mice. The estrogen-induced changes of the pro-inflammatory cytokines, TNF-α, IL-1β, and IL-6, are significantly inhibited by NK1R agonists. SP may be a mediator of estrogen regulating pro-inflammatory factors in IDD. Estrogen may affect IVD inflammation through two ways: one is to directly affect the level of pro-inflammatory cytokines and the other is by means of modulation of SP.
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Affiliation(s)
- Xiao-Xing Song
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Lu, Shanghai, 200025, China
| | - Lin-Yu Jin
- Department of Spinal Surgery, Peking University People's Hospital, Peking University, Beijing, 100044, China
| | - Xin-Feng Li
- Department of Spine Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630, Dongfang Rd, Shanghai, 200127, People's Republic of China.
| | - Yan Luo
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Lu, Shanghai, 200025, China
| | - Bu-Wei Yu
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Lu, Shanghai, 200025, China.
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Callan NGL, Woods NF. Treatment of Midlife Women with Chronic Low Back Pain—Opioids Are a Last-Resort Option. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2020. [DOI: 10.1007/s13669-020-00286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:299. [PMID: 32355743 PMCID: PMC7186678 DOI: 10.21037/atm.2020.02.175] [Citation(s) in RCA: 591] [Impact Index Per Article: 147.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Low back pain (LBP) is a common musculoskeletal problem globally. Updating the prevalence and burden of LBP is important for researchers and policy makers. This paper presents, compares and contextualizes the global prevalence and years lived with disability (YLDs) of LBP by age, sex and region, from 1990 to 2017. Methods Data were extracted from the GBD (the Global Burden of Disease, Injuries, and Risk Factors Study) 2017 Study. Age, sex and region-specific analyses were conducted to estimate the global prevalence and YLDs of LBP, with the uncertainty intervals (UIs). Results The age-standardized point prevalence of LBP was 8.20% (95% UI: 7.31–9.10%) in 1990 and decreased slightly to 7.50% (95% UI: 6.75–8.27%) in 2017. The prevalent numbers of people with LBP at any one point in time in 1990 was 377.5 million, and this increased to 577.0 million in 2017. Age-standardized prevalence of LBP was higher in females than males. LBP prevalence increased with age, and peaked around the ages of 80 to 89 years, and then decreased slightly. Global YLDs were 42.5 million (95% UI: 30.2 million–57.2 million) in 1990 and increased by 52.7% to 64.9 million (95% UI: 46.5 million–87.4 million) in 2017. YLDs were also higher in females than males and increased initially with age; they peaked at 35–39 years of age in 1990, before decreasing, whereas in 2017, they peaked at 45–49 years of age, before decreasing. Western Europe had the highest number of LBP YLDs. Conclusions Globally, LBP is the leading global cause of YLDs. Greater attention is urgently needed to mitigate this increasing burden and the impact it is having on health and social systems.
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Affiliation(s)
- Aimin Wu
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Lyn March
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Surveillance Task Force, Global Alliance for Musculoskeletal Health (G-MUSC), Sydney, Australia
| | - Xuanqi Zheng
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Jinfeng Huang
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Xiangyang Wang
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Jie Zhao
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai 200011, China
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW Australia
| | - Emma Smith
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney & Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Damian Hoy
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Surveillance Task Force, Global Alliance for Musculoskeletal Health (G-MUSC), Sydney, Australia
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Wang XR, Kwok TCY, Griffith JF, Man Yu BW, Leung JCS, Wáng YXJ. Prevalence of cervical spine degenerative changes in elderly population and its weak association with aging, neck pain, and osteoporosis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:486. [PMID: 31700922 DOI: 10.21037/atm.2019.07.80] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background To investigate the prevalence of MRI degenerative findings of cervical spine in elderly Chinese males and females. Methods From a general population sample, cervical spine T2 weighted sagittal MR images were acquired in 272 males (mean age: 82.9±3.83) and 150 females (mean age: 81.5±4.27). Images were interpreted and degenerative changes were classified. Study subjects were divided into younger group (group A, ≤81 years) and older group (group B, >81 years). For neck pain, question was structured as 'during the past 12 months, have you had any neck pain?'. Two hundred and fifty-two males and 134 females also had hip bone mineral density (BMD) measured. Results 98.1% subjects exhibited at least one degenerative change at one or more vertebral levels. The C5/6 level had the highest overall frequency for degenerative changes. Most of the degenerative changes were more common in females. The older female group had higher prevalence or higher severity of degenerative findings than the younger group. Eleven point four percent of the males and 20.6% of the females reported neck pain, and male subjects with neck pain tended to have slightly higher prevalence of cervical degenerative changes. There was a weak trend that osteoporosis was associated with a higher prevalence of spinal cord high signal and a higher prevalence of spinal canal stenosis. Conclusions The age-dependence of cervical spine degenerative changes was more notable in females. Subjects with neck pain and subjects with osteoporosis were weakly associated with higher prevalence of cervical degenerative changes.
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Affiliation(s)
- Xiao-Rong Wang
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Radiology, Ningbo First Hospital, Ningbo 315000, China
| | - Timothy C Y Kwok
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Blanche Wai Man Yu
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C S Leung
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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22
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Abdominal pain during the menopause transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. Womens Midlife Health 2019; 5:2. [PMID: 31388434 PMCID: PMC6679532 DOI: 10.1186/s40695-019-0046-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 07/25/2019] [Indexed: 12/15/2022] Open
Abstract
Objective To assess the relationship between abdominal pain severity during the menopausal transition (MT) and age, MT stage, reproductive biomarkers, stress biomarkers, and stress perceptions. Methods Women ages 35-55 were recruited from multiethnic neighborhoods in the greater Seattle area from 1990 to 1992, for an original study cohort of 508. From 1990 to 2013, a subset of this cohort consented to ongoing annual data collection by annual health questionnaire, health diary, and daily menstrual calendar. Beginning in 1997, a portion of these women also provided a first morning voided urine specimen to be assayed for levels of estrone glucuronide (E1G), follicle stimulating hormone (FSH), testosterone, cortisol, norepinephrine, and epinephrine. To identify how changes in abdominal pain severity changed over time in relation to age, MT stage, reproductive biomarkers, stress-related biomarkers, and stress-related perceptions, mixed effects modeling was used. Results In a univariate model, E1G (p = 0.02) and testosterone (p = 0.02) were significantly and negatively related to abdominal pain severity, while perceived stress (p = 0.06), tension (p < 0.001), and anxiety (p < 0.001) were significantly and positively associated. In a multivariate model, increasing age (p = 0.001) and E1G (p = 0.04) were negatively associated with abdominal pain severity, and anxiety (p = 0.00) positively associated. Testosterone did not improve the fit to the final model, nor did tension or perceived stress. Conclusions These results suggest that age, anxiety, and E1G each show a significant association with abdominal pain severity in the MT. In contrast, stress perception, tension, testosterone, stress biomarkers, and MT stage do not. These factors should be evaluated further in research on abdominal pain experienced during the MT and early postmenopause years.
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23
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The prevalence and years lived with disability caused by low back pain in China, 1990 to 2016: findings from the global burden of disease study 2016. Pain 2019; 160:237-245. [PMID: 30234697 PMCID: PMC6319591 DOI: 10.1097/j.pain.0000000000001396] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Supplemental Digital Content is Available in the Text. The China data of GBD 2016 found that 6.73 × 107 individuals had low back pain, and the prevalence was 4.2%. The years lived with disability were 7.7 million and years lived with disability rate was 481.9/100,000. The aim of this work was to quantify the prevalence and years lived with disability (YLDs) caused by low back pain (LBP) in China from 1990 to 2016. Data from the GBD 2016 (Global Burden of Diseases, Injuries, and Risk Factors Study 2016) were used. We analyzed the age-sex-province-specific prevalence and YLDs for LBP of 33 provinces/regions in China. Comparisons were made with the data retrieved from the 1990 GBD study. We estimated that 5.45 × 107 individuals had LBP in 1990, which rose to 6.73 × 107 in 2016. The age-standardized prevalence of LBP decreased from 5.6% (95% uncertainty interval [95% UI]: 4.9%-6.3%) in 1990 to 4.2% (95% UI: 3.8%-4.8%) in 2016. The YLDs for LBP increased from 6.2 million (95% UI: 4.3-8.3 million) in 1990 to 7.7 million (95% UI: 5.4-10.2) in 2016. Age-standardized YLD rate (per 100,000 person) decreased from 637.5 (95% UI: 449.9-848.8) in 1990 to 481.9 (95% UI: 338.6-637.0) in 2016. A female preponderance was observed for prevalence and YLDs. The prevalence and YLDs rate for LBP slightly decreased from 1990 to 2016 in China; however, the total individuals and YLDs increased. Low back pain still ranks as the second leading cause of YLD burden disease in China. Considerable attention should be paid for LBP, especially in the female population.
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Thoracolumbar Intervertebral Disc Area Morphometry in Elderly Chinese Men and Women: Radiographic Quantifications at Baseline and Changes at Year-4 Follow-up. Spine (Phila Pa 1976) 2018; 43:E607-E614. [PMID: 29112101 DOI: 10.1097/brs.0000000000002482] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A population-based radiographic study with longitudinal follow-up. OBJECTIVE To develop a quantitative index for lumbar disc space narrowing (DSN) evaluation in elderly subjects; to determine how DSN in the elderly is influenced by osteoporosis and sex. SUMMARY OF BACKGROUND DATA There is paucity of research on quantitative classification of lumbar DSN based on disc areal morphometry. METHODS With the database of Osteoporotic Fractures in Men (Hong Kong) and Osteoporotic Fractures in Women (Hong Kong) Studies and those who attended the year-4 follow-up (n = 1519 for men and n = 1546 for women), data of 491 women and 592 men were randomly selected. The anterior, middle, and posterior heights; anteroposterior diameter; and area of intervertebral discs (T4T5 to L4L5) were measured on lateral radiographs. Disc area index for lumbar spine (DAIL, disc area divided by the mean of the sum of square of the adjacent upper and lower vertebrae mid-height anterior-posterior diameter) was developed and compared with semiquantitative DSN expert grading. RESULTS DAIL correlated with semiquantitative grading, with sensitivity and specificity varying from 87.3% to 96.8% for grade 1 DSN (<30% reduction in disc height), and 92.9% to 100% for grade 3 DSN (>60% reduction in disc height). The thoracolumbar disc area loss among men and women during 4-years' follow-up period varied between 1.32% and 3.56%, and it was greater for women (mean: 2.44%) than for men (mean: 1.90%, P = 0.044). Majority of lumbar DSN progressions during 72 to 76 years old were progression from normal disc space to grade 1 DSN. Osteoporosis was associated with greater disc area decrease, both for thoracic and lumbar discs. CONCLUSION Lumbar DSN can be quantified using DAIL. In elderly Chinese, intervertebral disc narrowing over a 4-year period was greater in women than men, and associated with the presence of osteoporosis. LEVEL OF EVIDENCE 3.
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Park JH, Hong JY, Han K, Han SW, Chun EM. Relationship between hormone replacement therapy and spinal osteoarthritis: a nationwide health survey analysis of the elderly Korean population. BMJ Open 2017; 7:e018063. [PMID: 29127229 PMCID: PMC5695470 DOI: 10.1136/bmjopen-2017-018063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To identify the effects of hormone replacement therapy (HRT) on spinal osteoarthritis (OA). METHODS AND DESIGN A cross-sectional study of a nationwide survey was performed. SETTING This study collected data from the fifth Korean National Health and Nutrition Examination Survey (2010-2012). PARTICIPANTS After excluding ineligible respondents, the total number of participants in this study was 4265 females. Participants were asked to report symptoms and disabilities related to spinal OA. In addition, plain radiographs of the spine were taken of all patients. PRIMARY AND SECONDARY OUTCOME MEASURES Demographic and lifestyle variables were compared between the HRT and non-HRT groups. In addition, radiographic examination and symptom assessment were performed to determine the existence of spinal OA. RESULTS Marital status, education, income and HRT were correlated with spinal OA. A risk analysis of related factors showed that HRT and age had effects on spinal OA (ORs 0.717 and 1.257). Nevertheless, in the HRT group, smokers had a increased risk of spinal OA. In addition, the HRT group demonstrated a lower prevalence of spinal OA. The calculated risk for compromised morbidity with HRT compared with the prevalence of spinal OA was 0.717 (OR). The duration of HRT was also related to the risk for spinal OA. The group that had been taking HRT for more than 1 year showed decreased risk (OR 0.686) compared with patients with <1 year of HRT (OR 0.744; P<0.05). CONCLUSION Women receiving HRT showed a lower prevalence of spinal OA. HRT also correlated with a decrease in spinal OA morbidity.
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Affiliation(s)
- Jung-Ho Park
- Department of Orthopedics, Korea University Ansan Hospital, Seoul, Republic of Korea
| | - Jae-Young Hong
- Department of Orthopedics, Korea University Ansan Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University, Seoul, Republic of Korea
| | - Seung-Woo Han
- Department of Orthopedics, Korea University Ansan Hospital, Seoul, Republic of Korea
| | - Eun Mi Chun
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Woman’s University Mokdong Hospital, Seoul, Republic of Korea
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Wang YXJ, Káplár Z, Deng M, Leung JCS. Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat 2016; 11:39-52. [PMID: 29662768 PMCID: PMC5866399 DOI: 10.1016/j.jot.2016.11.001] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The epidemiology of lumbar degenerative spondylolisthesis (DS) remains controversial. We performed a systematic review with the aim of gaining a better understanding of the prevalence of DS in the general population. The results showed that the prevalence of DS is very gender- and age-specific. Few women and men develop DS before they are 50 years old. After 50 years of age, both women and men begin to develop DS, with women having a faster rate of development than men. For elderly Chinese (≥ 65 years, mean age: 72.5 years), large population-based studies MsOS (Hong Kong, females: n = 2000) and MrOS (Hong Kong, males: n = 2000) showed DS prevalence was 25.0% in women and 19.1% in men. The female:male (F:M) prevalence ratio was 1.3:1. The published data for MsOS (USA) and MrOS (USA) studies seem to show that elderly Caucasian Americans have a higher DS prevalence, being approximately 60-70% higher than elderly Chinese; however, the F:M prevalence ratio was similar to the elderly Chinese population. Patient data showed that female patients more often received surgical treatment than male and preliminary data showed the ratio of female to male patients receiving surgical treatment did not differ between Northeast Asians (Chinese, Japanese, and Korean), Europeans, and American Caucasians, being around 2:1 in the elderly population. The existing data also suggest that menopause may be a contributing factor for the accelerated development of DS in postmenopausal women. The translational potential of this article: A better understanding of epidemiology of lumbar degenerative spondylolisthesis can support patient consultation and treatment planning.
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Affiliation(s)
- Yi Xiang J Wang
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Zoltán Káplár
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Min Deng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
| | - Jason C S Leung
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region
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