Goal of the article?
The goal of this study, 1 is to examine why there is an increasing incidence of disc herniation in young people.
Why are they doing this review?
Disc herniation is often the result of natural degeneration changes accompanied by age as the vertebral discs lose water and become less resilient and less responsive to dynamic shock. However, increasingly, disc herniations are appearing in younger people. The cause of this early degeneration is most likely from inactivity sustained by static compressive loads, as well as other factors such as smoking, obesity, familial predisposition and other factors like prolonged sitting. As this can have long-term implications, understanding causes and potential treatments of early degeneration is critical to minimizing the negative outcomes for individuals and society at large.
What was done?
This is a prospective study with a total of 33 young patients, all with extruded lumbar disc herniations managed by conservative or surgical approaches between 2017 and 2018. On average, patients were 25 years old. In addition to age, the researchers asked each patient about smoking, familial predisposition, sporting activity, and occupation. They measured pain using a visual analog scale (VAS) and measured patients’ BMI. All patients had lumbar MRI imaging.
Helping patients understand compressive loads with a Dynamic Disc Model
What did they find?
The researchers found that 18 patients (8 females and 10 males) had a disc extrusion at the L5-S1 level, 12 patients (8 females and 4 males) had a disc extrusion at the L4 and L5 level, and 3 patients had a disc extrusion at both the L4-L5 and L5-S1 levels. Motor deficits were detected in 4 patients who then required surgical treatment. For these patients, three procedures involved the L4-L5; one had right L5 radiculopathy and motor deficit, while the others were on the left side.
The remaining 29 patients were treated conservatively with physical therapy and pain medication. They were given information on ergonomics and help with stopping smoking. In follow-up, the VAS scores were reduced, and all patients had lost weight. However, only three patients had quit smoking.
When the researchers looked at occupations, they found that all patients sat during the day and lacked movement. They also found that 61% of the patients were smokers and the mean BMI was 32.5 kg/m2. Additionally, in line with existing research, this study found that familial predisposition with lumbar disc herniation played a role.
Why do these findings matter?
Understanding factors contributing to early disc degeneration can help patients make lifestyle changes that can postpone pain and mobility issues.