Videman Tapio, Levälahti Esko, Battié Michele C
University of Alberta, Edmonton, Alberta, Canada.
Spine (Phila Pa 1976). 2007 Jun 1;32(13):1406-13. doi: 10.1097/BRS.0b013e31806011fa.
A cross-sectional study design was used.
The objective was to examine the influences of body anthropometrics, axial disc area, and lifting strength on disc degeneration and to compare these with the effects of lifetime physical demands and age.
Although recent studies have shown that heredity is a dominant factor in disc degeneration, the common notion that occupational physical loading is the major risk factor persists. However, substantial variations in disc degeneration, particularly at the lowest lumbar levels, remain unexplained by heredity or occupational physical demands.
Univariate methods and stepwise multiple regression modeling were used to estimate associations of body height, weight, fat content, axial disc area, isokinetic lifting performance, and lifetime routine physical activities at work and leisure with disc height narrowing and disc signal (in T2 images) based on lumbar MRIs. These data were available from a population sample of 600 men, 35 to 70 years of age.
Lower disc signal, representing disc desiccation, was associated with higher age, lower body mass and lifting strength, and larger axial disc area. Of the variance in disc signal, age explained 8.0% (P < 0.001) and body weight/axial disc area, isokinetic lifting strength, and occupational lifting history added 3.9%, 2.3%, and 1.3%, respectively. Greater disc narrowing was associated with higher age, larger axial disc area, and higher occupational physical loading. Of the variance in disc narrowing, age accounted for 3.8% (P < 0.001); axial disc area and occupational loading added 1.9% (P < 0.004) and 1.3% (P < 0.007), respectively.
Body weight, lifting strength, and axial disc area were more highly associated with disc degeneration than occupational and leisure physical activity histories, although all had modest influences. Furthermore, higher body mass, greater lifting strength, and heavier work were all associated with more disc height narrowing but less disc desiccation contrary to current views. Smaller discs appeared to have beneficial effects.
采用横断面研究设计。
旨在研究身体人体测量学指标、椎间盘轴向面积和举重力量对椎间盘退变的影响，并将这些影响与终生体力需求和年龄的影响进行比较。
尽管最近的研究表明遗传是椎间盘退变的主要因素，但职业体力负荷是主要危险因素这一普遍观念仍然存在。然而，椎间盘退变的显著差异，尤其是在腰椎最低节段，无法用遗传因素或职业体力需求来解释。
基于腰椎MRI，采用单变量方法和逐步多元回归模型，估计身高、体重、脂肪含量、椎间盘轴向面积、等速举重能力以及工作和休闲时的终生日常体力活动与椎间盘高度变窄和椎间盘信号（T2图像）之间的关联。这些数据来自600名年龄在35至70岁之间的男性人群样本。
代表椎间盘脱水的较低椎间盘信号与较高年龄、较低体重和举重力量以及较大的椎间盘轴向面积相关。在椎间盘信号的变异中，年龄解释了8.0%（P < 0.001），体重/椎间盘轴向面积、等速举重力量和职业举重史分别增加了3.9%、2.3%和1.3%。更大程度的椎间盘狭窄与较高年龄、较大的椎间盘轴向面积和较高的职业体力负荷相关。在椎间盘狭窄的变异中，年龄占3.8%（P < 0.001）；椎间盘轴向面积和职业负荷分别增加了1.9%（P < 0.004）和1.3%（P < 0.007）。
体重、举重力量和椎间盘轴向面积与椎间盘退变的相关性高于职业和休闲体力活动史，尽管所有因素的影响都较小。此外，与当前观点相反，较高的体重、较大的举重力量和较重的工作都与更多的椎间盘高度变窄但较少的椎间盘脱水相关。较小的椎间盘似乎有有益的影响。
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