Underlying Causes of Lumbar Disc Disease in Young Adults

Authors

  • GHULAM MUSFAFA WARDAK Departments of Neurosurgery,
  • HAMEEDULLAH KAKAR PANIZAI Departments of Neurosurgery
  • NAQEEBULLAH ACHAKZAI Departments of Neurosurgery,

Keywords:

Lumbar disc herniation, Disc prolapsed,, Etiological factors of disc herniation

Abstract

Background: Rationale of the study was to gather data about the underlying causes of lumbar disc herniation in young adults as awareness of these etiological factors will help the clinician extract a relevant medical history, perform a directed physical examination, and order appropriate imaging studies. This will aid in initiating early intervention, be it conservative or operative, and achieving a favorable outcome.
Purpose: To determine the underlying causes of lumbar disc herniation in young patients.
Materials and Methods: This Descriptive Cross – sectional study was conducted at Department of Neuro-surgery, Sandeman Provincial Hospital, Quetta. A total of seventy five (n = 75) adult patients of either gender less than 30 years of age with chronic back pain were included in the study. Underlying causes were ascertained through detailed history and clinical examination. Subsequently, all patients underwent MRI for the detection of the prolapse.
Results: 72% (n = 54) of patients were males and 28% (n = 21) were females 81.3% (n = 61) were found to have disc herniation due to mechanical load (trauma, RTA, weight lifting). 16.0% (n = 12) had systemic disease and 2.7% (n = 2) had a positive family history indicating genetic etiology. Out of 61 patients where underlying cause was mechanical load, 21 patients gave history of trauma, 19 had history of RTA. 14 were long distant drivers and 7 had history of heavy weight lifting.
Conclusion: In this study, mechanical load (trauma, RTA, long distant drivers and weight lifting) was found to be the major underlying cause of lumbar disc herniation in young adults.

References

1. Dong DM, Yao M, LiumB, Sun CY, Jiang YQ, Wang YS. Association between the 1306C/T polymorphism of matris metalloproteinase – 2 gene and lumbar disc disease in Chinese young adults. European Spine Jour-nal, 2007; 16: 1958-61. 2. Tilkeridis C, Bei T, Garantziotis S, Stratakis CA. asso-ciation of a COLIAI polymprphism with lumbar disc disease in young military recruits. Journal of medical genetics, 2005; 42: e44. 3. Kim MS, Park K, Hwang C, Lee Y, Koo KH, Chang BS, et al. Recurrence rate of lumbar disc herniation after open discectomy in active young men. Spine, 2009; 34: 24-9. 4. Parisini P, Silvestre MD, Greggi T, Miglietta A, Pade-rni S. Lumbar disc excision in children and adolescents. Spine, 2001; 26: 1997-2000. 5. Paajanen H, Erkintalo M, Kuusela T, Dahlstrom S, Kor-mano M. Magnetic resonance study of disc degenerat-ion in young low – back pain patients. Spine, 1989; 14: 982-5. 6. Kerttula LI, Serlo WS, Tervonen OA, Pääkkö EL, Van-haranta HV. Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study. Spine, 2000; 25: 1104-8. 7. Takatalo J, Karppinen J, Niinimäki J, Taimela S, Näyhä S, Mutanen P, et al. Does lumbar disc degeneration on magnetic resonance imaging associate with low back symptom severity in young Finnish adults? Spine, 2011; 36: 2180-9. 8. Khoury NJ, Hourani MH, Arabi MM, Abi – Fakher F, Haddad MC. Imaging of back pain in children and adolescents. Curr Probl Dian Radiol. 2006; 35: 224-44. 9. DePalma MJ, Bhargava A. Nonspondylolytic etiologies of lumbar pain in the young athlete. Curr Sports Med Rep. 2006; 5: 44-9. 10. Micheli LJ, Wood R. Back pain in young athletes. Sig-nificant differences from adults to causes and patterns. Arch Pediatr Adolesc Med. 1995; 149: 15-8. 11. Varlotta GP, Brown MD, Kelsey JL, Golden AL. Fami-lial predisposition for herniation of a lumbar disc in pat-ients who are less than twenty – one years old. J Bone Joinr Surg Am. 1991; 73: 124-8. 12. Samartzis D, Karppinen J, Mok F, Fong DY, Luk KD, Cheung MK. A population – based study of juvenile disc degeneration and its association with overweight and obesity, low back pain and diminished functional status. J Bone Joint Surg Am. 2011; 93: 662-70. 13. Martinez – Lage JF, Martinez Robledo A, Lopez F, Poza M. Disc protrusion in the child. Particular features and comparison with neoplasms. Childs Nerv Syst. 1997; 13: 201-7.

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Published

2018-09-30

Issue

Vol. 19 No. 2 (2015): April-June

Section

Editorial

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The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).