Mundt D J, Kelsey J L, Golden A L, Pastides H, Berg A T, Sklar J, Hosea T, Panjabi M M
National Academy of Science, Institute of Medicine, Washington, DC.
Spine (Phila Pa 1976). 1993 Apr;18(5):595-602. doi: 10.1097/00007632-199304000-00012.
An epidemiologic case-control study of herniated lumbar intervertebral disc was conducted in Springfield, Massachusetts, New Brunswick, New Jersey, and New York, New York, to evaluate the role of several possible risk factors in the etiology of this disorder. Patients with signs and symptoms of herniated lumbar disc (N = 287) were matched to control subjects without back pain by age, sex, source of care, and geographic area. Of the total case-subject group, 177 were confirmed by surgery, computed tomographic scan, myelogram, or magnetic resonance imaging. This article focuses on non-occupational lifting, an activity not previously reported on. Frequent lifting of objects or children weighing 25 or more pounds with knees straight and back bent was associated with increased risk of herniated lumbar disc. This association was particularly strong among confirmed case subjects (relative risk = 3.95). Positive associations among confirmed case subjects were also seen for frequent lifting with arms extended (relative risk = 1.87) and twisting while lifting (relative risk = 1.90). No associations were found for frequent stretching or carrying. If confirmed in other investigations, these data suggest that instruction in lifting techniques should be extended into the home.
在马萨诸塞州的斯普林菲尔德、新泽西州的新不伦瑞克以及纽约市进行了一项关于腰椎间盘突出症的流行病学病例对照研究,以评估几种可能的危险因素在该疾病病因中的作用。有腰椎间盘突出症体征和症状的患者(N = 287)按照年龄、性别、医疗保健来源和地理区域与无背痛的对照受试者进行匹配。在整个病例组中,177例通过手术、计算机断层扫描、脊髓造影或磁共振成像得到确诊。本文重点关注非职业性提举,这是一种此前未被报道过的活动。频繁伸直膝盖且背部弯曲提举25磅及以上的物品或儿童与腰椎间盘突出症风险增加相关。这种关联在确诊病例中尤为明显(相对风险 = 3.95)。在确诊病例中,伸直手臂频繁提举(相对风险 = 1.87)和提举时扭转身体(相对风险 = 1.90)也呈现出正相关。频繁伸展或搬运未发现有相关性。如果在其他研究中得到证实,这些数据表明提举技术指导应延伸至家庭。