A Case-Control Study On The Risk Factors Of Lumbar Disc Herniation

Objective:To estimate the risk factors of lumbar disc herniation, and to provide scientific evidence for prevention from lumbar disc herniation.Methods:A hospital based 1:1 matched case-control study was carried out.262 patients diagnosed as lumbar disc herniation in accord with Spine Surgery were taken as the case group,which recruited from December 15th,2006 to July 15th,2007at the Second Affiliated Hospital of XiangYa of Central South University,the Third Affiliated Hospital of XiangYa of Central South University,People's Hospital of Hunan Province,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Hunan Institute of Chinese Medicine,the Fourth People's Hospital of Changsha,Affiliated Xiangdong Hospital of Hunan Normal University,and the Second People's Hospital of Yueyang. According to match qualification(the same gender,race,region, occupation and age differing within 3 years,and the same hospital),262 patients and caregivers were recruited as control group,who were diagnosed without lumbar disc herniation,without serious internal diseases,without serious mental abnormality,and no other spine disease. The self-designed questionnaire was used to collect the information on geographic characterestus,occupation,life style,psychological factors, and biological factors.Pair Chi-square test,Paired t-test and conditional logistic regression model were used for univafiate and multivariate analysis to estimate odds ratios((?))and the 95%confidence interval (95%CI).Results:The results of univariate analysis showed that higher education level(x~2=8.471,P=0.004),B category work postures (x~2=108.900,P=0.000),long time of univalent work(x~2=12.115,P=0.001), heavier load of spinal(x~2=5.233,P=0.022),working environment with air-conditioning(x~2=6.259,P=0.012),favouring spicy food(x~2=26.304, P=0.000),a lot of plasticity of bed(x~2=10.618,P=0.001),humid residence(x~2=8.000,P=0.005),higher monthly income than other people (x~2=4.719,P=0.030),family history of LDH in direct relatives (x~2=18.050,P=0.000)and obesity(x~2=11.130,P=0.001)were associated with lumbar disc herniation.Meanwhile,angle of bending(P＞0.05), repetitive bending during work(P＞0.05),types of load(P＞0.05),schedule of work(P＞0.05),smoking(P＞0.05),drinking(P＞0.05),frequent physical exercises(P＞0.05),personality(P＞0.05),the number of people living together(P＞0.05),ever suffering from diabetes(P＞0.05)were not associated with lumbar disc herniation.The results of multivariate logistic regression analysis showed that B category work postures((?)=11.314, 95%CI:5.820～21.993),long time of univalent work((?)=2.805,95%CI: 1.485～5.295),heavier load of spinal((?)=5.108,95%CI:1.706～15.300), favouring spicy food((?)=2.638,95%CI:1.417～4.914),a lot of plasticity of bed((?)=2.020,95%CI:1.167～3.497),humid residence((?)=2.351, 95%CI:1.103～5.010),family history of LDH in direct relatives ((?)=2.502,95%CI:1.146～5.460)and obesity((?)=2.341,95%CI: 1.195～4.588)were associated with lumbar disc herniation.Conclusion:B category work postures,long time of univalent work, heavier load of spinal,favouring spicy food,a lot of plasticity of bed, humid residence,family history of LDH in direct relatives and obesity may be the risk factors of lumbar disc herniation.People can reduce or eliminate the risk of lumbar disc herniation by adopting healthy life style and eating habit,developing health education,enhancing the awareness of self-protection.