Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 12)
Relation between grades of intervertebral disc degeneration and occupational activities of patients with lumbar disc herniation
Authors:
Monika Papić, Vladimir Papić, Milena Kresoja, Valerija Munteanu, Ivan Mikov, Tomislav Cigić
Background/Aim. Intervertebral disc degeneration (IDD)occurs as consequence of combined effects of genetic, agerelated,
environmental and occupational factors. Lumbar
disc herniation (LDH) develops mostly due to IDD. The
aim of this study was to investigate whether the frequency
of LDH is higher at the level of the most pronounced IDD,
and whether a category of physical workload influences
higher IDD on level L3-L4, L4-L5 and L5-S1 separately.
Methods. The research included 60 patients with permanent
employment, hospitalized due to LDH. A grade of
IDD was assessed by lumbosacral preoperative magnetic
resonance imaging (MRI), according to Pfirmann's MRI
classification system. Occupational factors were determined
by a specific questionnaire. Results. Out of the 60 patients
participating in the study, 33.3% had jobs with easy workload,
23% had moderate workload, while 43% had heavy
workload. Herniated discs were found at level L3-L4 in
8.3%, at level L4-L5 in 46.7% and at level L5-S1 in 45% patients.
The symptomatic discs at level L5-S1 showed statistically
significant frequency of degenerative changes of grades
IV and V. Binary logistic regression results showed that the
strongest predictor of IDD grade for examined levels was
physical workload. Positive association of physical workload
and IDD grade was observed in all cases. Higher grades of
IDD are more likely for patients with both higher TE and
heavier physical workload (OR 2.011) at level L3-L4. At
levels L4-L5 and L5-S1 higher degree of IDD was more
likely for females with heavier physical workload (OR 1.978
and 2.433 respectively). Conclusion. Symptomatic discs
show higher frequency of higher grades of IDD but herniation
does not occur solely at the disc of the most prominent
degenerative changes. The results suggest importance of inter-
influence of physical workload and the years of
employment and the inter-influence of physical workload
and gender, on degeneration of lumbar discs.
