A Case-Control Study of Risk Factors Associated to Intravertebral Spinal Disc Degeneration in Greece

Abstract

Objective. Few data exist concerning the natural history of degenerative spinal osteoarthritis (OA) and its associated risk factors. The aim of this Greek case-control study is to examine risk factors that have been previously shown or hypothesized to be correlated to spinal intravertebral disc degeneration (IDD).

Study Design. From May 2009 to December 2012, 818 matched pairs (cases and controls) were recruited and participated in the case-control study. All clinical data were collected through a detailed interview and meticulous clinical and radiological evaluation.  The severity of disease was determined by radiological Kellgren-Lawrence (K/L) grades and Lanes scores.

Results. Female gender (p=0.001), old age, BMI (p=0.06), heavy bodily fatigue (p=0.031), lower educational level (p=0.019) and osteopenia or osteoporosis (p=0.005 and p=0.0005, respectively) were significantly associated to increased risk of spinal intravertebral disc degeneration. In the female subgroup population, menopause was a significant risk factor (p=0.012) · breast feeding, on the contrary, was protective and associated to a decreased probability of IDD (p=0.013). No significant difference was found between the two groups as far as smoking status was concerned.

Conclusions. Systemic risk factors play a role in the aetiology of spinal IDD in Greece. Female sex, overweight, heavy bodily fatigue, lower educational level and decreased bone density statuses are strongly associated with the diagnosis of symptomatic disease.