Vaajala Matias, Teuho Alisa, Liukkonen Rasmus, Ponkilainen Ville, Rimpelä Arja, Koivusilta Leena K, Mattila Ville M
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland.
Spine (Phila Pa 1976). 2024 Dec 15;49(24):1750-1757. doi: 10.1097/BRS.0000000000005112. Epub 2024 Aug 6.
Retrospective longitudinal study.
This study aims to investigate the influence of adolescent health-related behaviors (physical activity, high BMI, drunkenness, smoking), self-reported chronic disease, and low socioeconomic status (SES) on the development of low back pain requiring hospitalization or surgery.
The baseline data were surveys gathered biennially in 1981-1997 (the Adolescent Health and Lifestyle Survey) and individually linked with outcome data, degenerative low back pain hospitalizations, and spine surgeries retrieved from the Care Register for Health Care. A total of 47,724 participants were included. Explanatory variables included physical activity, high BMI, smoking, monthly drunkenness, chronic diseases, and family SES.
A logistic regression model was used to analyze the influence of adolescent health-related behaviors (physical activity, high BMI, drunkenness, smoking), self-reported chronic disease, and low SES on degenerative low back pain hospitalization, lumbar disc herniation (LDH) hospitalization, and/or spine surgery. Covariates were selected using directed acyclic graphs (DAGs).
A total of 5538 participants had degenerative low back pain hospitalizations, 2104 had LDH hospitalizations, and 913 had spinal surgery over an average of 27-year follow-up. High BMI [adjusted odds ratio (aOR): 1.25, CI: 1.12-1.38], smoking (aOR: 1.53, CI: 1.43-1.62), monthly drunkenness (aOR: 1.17, CI: 1.10-1.26), and chronic diseases (aOR: 1.47, CI: 1.35-1.61) in adolescence increased the odds of hospitalizations during follow-up. In addition, high BMI (aOR: 1.37, CI: 1.09-1.72), smoking (aOR: 1.40, CI: 1.21-1.61), and monthly drunkenness (aOR: 1.19, CI: 1.01-1.39) increased the odds of spine surgeries.
We found that smoking, high BMI, monthly drunkenness, chronic diseases, and low family SES in adolescence increased the likelihood of degenerative low back pain hospitalizations in adulthood. In addition, high BMI, smoking, and monthly drunkenness in adolescence increased the odds of spinal surgeries.
回顾性纵向研究。
本研究旨在调查青少年健康相关行为（体育活动、高体重指数、醉酒、吸烟）、自我报告的慢性病以及低社会经济地位对需要住院治疗或手术的腰痛发展的影响。
基线数据是在1981年至1997年期间每两年收集一次的调查（青少年健康与生活方式调查），并与从医疗保健登记册中检索到的结局数据、退行性腰痛住院病例和脊柱手术数据进行个体关联。共纳入47724名参与者。解释变量包括体育活动、高体重指数、吸烟、每月醉酒情况、慢性病以及家庭社会经济地位。
采用逻辑回归模型分析青少年健康相关行为（体育活动、高体重指数、醉酒、吸烟）、自我报告的慢性病以及低社会经济地位对退行性腰痛住院、腰椎间盘突出症（LDH）住院和/或脊柱手术的影响。使用有向无环图（DAGs）选择协变量。
在平均27年的随访期间，共有5538名参与者有退行性腰痛住院经历，2104名有LDH住院经历，913名接受了脊柱手术。青少年时期高体重指数[调整优势比（aOR）：1.25，可信区间（CI）：1.12 - 1.38]、吸烟（aOR：1.53，CI：1.43 - 1.62）、每月醉酒（aOR：1.17，CI：1.10 - 1.26）以及慢性病（aOR：1.47，CI：1.35 - 1.61）会增加随访期间住院的几率。此外，高体重指数（aOR：1.37，CI：1.09 - 1.72）、吸烟（aOR：1.40，CI：1.21 - 1.61）和每月醉酒（aOR：1.19，CI：1.01 - 1.39）会增加脊柱手术的几率。
我们发现青少年时期吸烟、高体重指数、每月醉酒、慢性病以及低家庭社会经济地位会增加成年后退行性腰痛住院的可能性。此外，青少年时期高体重指数、吸烟和每月醉酒会增加脊柱手术的几率。
