Epidemiology of Lumbar Disc Degeneration
The World Health Organization defines epidemiology as the study of the distribution and determinants of health-related states or events (WHO 2012). This chapter on the epidemiology of disc degeneration begins with a brief overview of the early observation
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Epidemiology of Lumbar Disc Degeneration Yue Wang and Michele C. Battié
9.1
Contents 9.1
Overview ........................................................................
139
9.2 9.2.1 9.2.2
Historical Perspective ................................................... Disc Degeneration ........................................................... Degenerative Disc Disease ..............................................
139 139 140
9.3
Case Definition: Measuring Disc Degeneration..........
142
9.4
Prevalence of Disc Degeneration..................................
143
9.5
Etiological Factors (Environmental, Behavioral, and Constitutional) ................................... Age .................................................................................. Occupational and Leisure Physical Demands and Spinal Loading ......................................................... Driving and Whole-Body Vibration ................................ Trauma ............................................................................ Smoking .......................................................................... Vertebral Endplate Morphology and Status .................... Genetic Influences ...........................................................
9.5.1 9.5.2 9.5.3 9.5.4 9.5.5 9.5.6 9.5.7 9.6
145 146 147 148 149 149 149 150
Summary of Critical Concepts Discussed in the Chapter ..............................................
153
References ....................................................................................
154
Y. Wang (*) Department of Orthopedic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China e-mail: [email protected] M.C. Battié Faculty of Rehabilitation Medicine, University of Alberta, 8205 114St, Edmonton, AB T6G 2G4, Canada e-mail: [email protected] I.M. Shapiro, M.V. Risbud (eds.), The Intervertebral Disc, DOI 10.1007/978-3-7091-1535-0_9, © Springer-Verlag Wien 2014
Overview
The World Health Organization defines epidemiology as the study of the distribution and determinants of health-related states or events (WHO 2012). This chapter on the epidemiology of disc degeneration begins with a brief overview of the early observations of disc degeneration and growing interest in the phenomenon, including the introduction and evolution of the currently ambiguous term “degenerative disc disease.” Attention is given to case definition, as it is a core concept in epidemiology and the study of occurrence rates. While definitions used for disc degeneration vary and depend greatly on the methods used to study or image the disc, the occurrence rates of degenerative findings reported in this chapter focus on population-based studies using MRI, which may provide a reference for clinical observations. Finally, we briefly discuss environmental, behavioral, and constitutional factors associated with accelerated disc degeneration, where there has been a recent dramatic shift in views.
9.2
Historical Perspective
9.2.1
Disc D
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