Correlation Between Body Mass Index And Adolescent Lumbar Disc Herniation

Objective:To investigate the correlation between body mass index(BMI)and adolescent lumbar disc herniation(ALDH).Methods:1.Retrospective analysis was conducted on 81 adolescent patients with lumbar intervertebral disc herniation admitted to department of spine surgery of China-Japan union hospital of Jilin university from August 2014 to February 2019.According to the classification criteria of body mass index(BMI),they were divided into three categories: normal BMI,overweight and obesity.The proportions of the three groups and the supernormal weight(overweight + obese)group in the total number of ALDH patients were calculated.The proportions of each group were compared with the proportions of the corresponding general population in the total number of samples,and the correlation between BMI and ALDH was analyzed.2.Lumbar MRI in the median sagittal T2 WI image of ALDH patients was observed.The degree of intervertebral disc degeneration was evaluated by Pfirrmann grades,and the relationship between intervertebral disc degeneration and herniation was analyzed.All ALDH patients were grouped according to their normal BMI,overweight,and obesity.ALDH patients with two or more protruding segments were counted and their proportions in the three BMI groups were compared.The relationship between body mass index and the number of protruding segments in the lumbar intervertebral disc was analyzed.The Pfirrmann grading composition ratio of intervertebral discs in each segment in the three groups was calculated and compared among the three groups,so as to determine the correlation between BMI and intervertebral disc degeneration.Results:1.The proportion of ALDH patients in the normal BMI group was significantly lower than that in the normal BMI group.The proportion of overweight was significantly higher than that of general population.The proportion of the obese group was significantly higher than that of the general population.The proportion of supernormal weight group was significantly higher than that of general population supernormal bmi group.After u test,all P values were less than 0.05,which was statistically significant.2.A total of 81 patients in the ALDH group had 405 intervertebral discs(L1-2 to L5-S1),among which 101(24.9%)had protruded intervertebral discs,and all of them had Grade III or above Pfirrmann degeneration.The proportion of patients with multiple segmentations among the three groups with different BMI was not statistically significant(P > 0.05).Overall,the majority of Pfirrmann Grade III and above intervertebral discs were distributed at the levels of L3-4,L4-5 and L5-S1.The majority of intervertebral discs in L1-2 and L2-3 segments are GradeI-II.From L1 to L5,the descending Pfirrmann degenerative grading level showed an increasing trend(the number of Grade I-II intervertebral discs decreased,and the number of Grade III and above increased),and the degenerative grade was concentrated in L4-5,L5-S1,which was parallel to the lumbar disc herniation segment.The proportion of Grade I intervertebral discs in the obese group was significantly lower than that in the normal group,and the proportion of Grade III and IV intervertebral discs in the obese group was significantly higher than that in the normal group,with statistically significant differences(P < 0.05).In terms of each segment,the proportion of Grade I intervertebral discs in L1-2 and L2-3 segments in the obese group was significantly lower than that in the normal group,and the proportion of Grade II intervertebral discs was significantly higher than that in the normal group.Grade III intervertebral discs began to appear in L2-3 segments in the obese group,but not in the other two groups.The proportion of Grade I intervertebral discs in the L3-4 segment in the obese group was significantly lower than that in the normal group,and the proportion of Grade III intervertebral discs was significantly higher than that in the normal group.The proportion of grade IV intervertebral disc in L4-5 segment and L5-S1 segment in the obese group was significantly higher than that in the normal group,and the above results were statistically significant(P < 0.05).Conclusion:BMI overweight and obesity are are associated with the incidence of adolescent lumbar disc herniation.High BMI is a risk factor for adolescent lumbar disc herniation.Obesity is correlated with the severity of adolescent lumbar intervertebral disc degeneration.The severity of adolescent lumbar intervertebral disc degeneration is parallel to that of adolescent lumbar disc herniation.Obesity can lead to adolescent lumbar disc herniation by accelerating adolescent lumbar disc degeneration.