Materiały źródłowe

• #1 Lumbar Disc Disease: Practice Essentials, Epidemiology, Presentation

  https://emedicine.medscape.com/article/249113-overview

  The lifetime prevalence of low back pain is 80%, with disk disorders being the most common cause of adult low back pain. The most consistent risk factor for degeneration is increasing age. […] The prevalence of a symptomatic herniated lumbar disc is about 1 to 3% in Finland and Italy, depending on age and sex. The highest prevalence is in persons 30 to 50 years of age, with a male-to-female ratio of 2:1. In persons 25 to 55 years of age, about 95% cases of herniated disc occur at the lower lumbar spine (L45 level); disc herniation above this level is more common in persons older than 55 years. […] Almost 5% of males and 2.5% of females experience sciatica at some time in their lifetime.

• #2 Herniated Lumbar Disk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0401/p1240.html

  The prevalence of symptomatic herniated lumbar disk is about 1 to 3 percent in Finland and Italy, depending on age and sex. The highest prevalence is among persons 30 to 50 years of age with a male-to-female ratio of 2:1. In persons 25 to 55 years of age, about 95 percent of herniated disks occur at the lower lumbar spine (L45 level); disk herniation above this level is more common in persons older than 55 years. […] Radiographic evidence of disk herniation does not reliably predict future low back pain or correlate with symptoms; 19 to 27 percent of asymptomatic persons have disk herniation on imaging. Risk factors for disk herniation include smoking (odds ratio [OR] 1.7; 95% confidence interval [CI], 1.0 to 2.5); weight-bearing sports (e.g., weight lifting, hammer throw); and certain work activities (e.g., repeated lifting). It has been suggested that driving a motor vehicle is a risk factor for disk herniation, although evidence is not conclusive (OR 1.7; 95% CI, 0.2 to 2.7).

• #3 Disc Herniation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441822/

  The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually and is most common in people in their third to fifth decade of life, with a man-woman ratio of 2:1. […] The estimated prevalence of symptomatic herniated discs of the lumbar spine is about 1% to 3% of patients. The prevalence is most significant among 30-50-year-olds. Patients between 25 and 55 years old have an approximately 95% chance of herniated discs occurring either at L4-L5 or L5-S1. […] Disc disease is the underlying etiology in less than five percent of patients with back pain.

• #4 Lumbar Disc Herniation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560878/

  Lumbar disc herniation is relatively common, with 5 to 20 cases per 1000 adults annually. LDH is most prevalent in the third to the fifth decade of life, with a male to female ratio of 2 to 1. […] Approximately 80% of the population sustains an episode of low back pain in their lifetime.

• #5 Herniated Disk (Bulging Disk): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/12768-herniated-disk

  Every year, more than 3 million people in the U.S. get a herniated disk. […] People ages 30 to 50 are most likely to get a herniated disk. The problem affects men twice as often women. […] Herniated disks get better on their own or with nonsurgical treatment for 9 out of 10 people.

• #6

  https://www.orthobullets.com/spine/2035/lumbar-disc-herniation

  Lumbar Disc Herniation is a very common cause of low back pain and unilateral leg pain, known as radiculopathy. In rare cases a large disc herniation can lead to Cauda Equina Syndrome which requires emergent diagnosis and treatment. […] Epidemiology: peak incidence is 4th and 5th decades. […] lifetime prevalence of 10%. […] only ~5% become symptomatic. […] Demographics: 3:1 male:female ratio. […] Location: L5/S1 most common level. […] 95% involve L4/5 or L5/S1 levels.

• #7 Chinese Association for the Study of Pain: Expert consensus on diagnosis and treatment for lumbar disc herniation

  https://www.wjgnet.com/2307-8960/full/v9/i9/2058.htm

  Lumbar disc herniation (LDH) is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease. […] Relevant foreign studies indicate that the incidence of LDH is around 2%-3%, while the incidence in men over 35 is about 4.8% and that in women is about 2.5%. […] According to the expert consensus, clinicians could adopt tailored and personalized diagnosis and treatment management strategies for LDH patients.

• #8 Herniated Disc In Cervical – Dr. Kevin Pauza, The Discseel® Procedure inventor

  https://drkevinpauza.com/herniated-disc-in-cervical/

  Cervical disc herniation is more common in women than men, and it increases as we age. Its most prevalent in those in the third to fifth decade of our lives. More than 60% of cases are females. The most common patients with this condition were those between the ages of 51 and 60. […] In adults, cervical herniated discs occur at a rate between 0.5% to 2%. However, cervical herniated discs can often go undiagnosed. Estimates could differ by population.

• #9 Disc herniation – Wikipedia

  https://en.wikipedia.org/wiki/Disc_herniation

  Disc herniation can occur in any disc in the spine, but the two most common forms are lumbar disc herniation and cervical disc herniation. The former is the most common, causing low back pain (lumbago) and often leg pain as well, in which case it is commonly referred to as sciatica. Lumbar disc herniation occurs 15 times more often than cervical (neck) disc herniation, and it is one of the most common causes of low back pain. The cervical discs are affected 8% of the time and the upper-to-mid-back (thoracic) discs only 12% of the time. […] Most disc herniations occur when a person is in their thirties or forties when the nucleus pulposus is still a gelatin-like substance. With age the nucleus pulposus changes („dries out”) and the risk of herniation is greatly reduced. After age 50 or 60, osteoarthritic degeneration (spondylosis) or spinal stenosis are more likely causes of low back pain or leg pain. […] 4.8% of males and 2.5% of females older than 35 experience sciatica during their lifetime. […] Of all individuals, 60% to 80% experience back pain during their lifetime. […] In 14%, pain lasts more than two weeks. […] Generally, males have a slightly higher incidence than females.

• #10 Lumbar Herniated Discs | The Bone School

  http://www.boneschool.com/spine/thoracolumbar/hnp/lumbar-hnpsciatica

  Sciatica 2/52 1.6% […] M:F = 1:1 […] Most common L4/5 […] Geere et al., BJJ 2023 – Retrospective cohort study 733 lumbar discectomies – 12% recurrence rate over 5y – Smoking was the major independent risk factor, HR 2.12.

• #11 Herniated Disk – Harvard Health

  https://www.health.harvard.edu/a_to_z/herniated-disk-a-to-z

  Herniated discs are rare in young people, but common among people aged 35 to 55. […] Herniated discs are most common in the lumbar and cervical regions. Herniated discs are relatively rare in the thoracic region, where they account for only 1 in every 200 to 400 disk herniations. […] About 60% of people respond to conservative therapy within one week, and 90% to 98% respond within six weeks. Surgical intervention has a high success rate when MRI or CT shows that the cause of the symptoms can be corrected.

• #12 Disc herniation – epidemiology – Disc herniation

  https://www.discherniation.eu/en/disc-herniation/disc-herniation-epidemiology

  Intervertebral disc herniation, with a 1-3% prevalence in developed countries, is the most common reason for a back surgery. […] Sources indicate, that 56% of the adult population suffer from disc herniation. The human spine has altogether 23 discs and the most common place for a herniation to occur is at the L4/L5 and L5/S1 levels.

• #13 Herniated discs: when is surgery necessary? in: EFORT Open Reviews Volume 6 Issue 6 (2021)

  https://eor.bioscientifica.com/view/journals/eor/6/6/2058-5241.6.210020.xml

  Cervical disc herniation (CDH) is a common source of cervical radiculopathy, with an annual incidence of 18.6 per 100,000, and peak presentation in the sixth decade of life. […] Epidemiologic studies have shown that the C7 root (C67 herniation) is the most commonly affected, followed by the C6 (C56 herniation) and C8 (C7T1 herniation) nerve roots. […] A recent systematic review found that substantial improvements in symptoms appear within four to six months, with time to complete recovery spanning 24 to 36 months in most patients. […] Symptomatic thoracic disc herniation (TDH) is a rare condition affecting 1 in 1,000 to 1 in 1,000,000 people in the general population, and makes up 0.1% to 3% of all spinal disc herniation. […] The majority of patients will respond favourably to non-operative treatment and observation, especially in cases of isolated back pain or isolated radicular pain due to intercostal nerve root entrapment. Surgical management for TDH is indicated if patients fail conservative measures (persistent axial back pain or intractable radiculopathy) and/or if they present with worsening neurological symptoms.

• #13 Herniated discs: when is surgery necessary? in: EFORT Open Reviews Volume 6 Issue 6 (2021)

  https://eor.bioscientifica.com/view/journals/eor/6/6/2058-5241.6.210020.xml

  Lumbar disc herniation (LDH) is the most common cause of sciatica, affecting 1% to 5% of the population annually. […] Absolute indications for an urgent surgical treatment are progressive and significant lower limb weakness or cauda equina syndrome. […] In line with the above evidence, the International Society for the Advancement of Spine Surgery recently released a policy regarding the treatment of patients with symptomatic LDH who fail to improve with non-surgical care.

• #14 Cervical disc herniation epidemiology [Neurosurgery Education Wiki]

  https://neurosurgery.education/wiki/doku.php?id=cervical_disc_herniation_epidemiology

  In a Hispanic Puerto Rico population, the most prevalent operated degenerative cervical disc levels were C5-C6 and C4-C5. […] Descriptions of the epidemiology of cervical disc herniation (CDH) can be gathered from a few large series, such as the highly cited study from the group in Rochester which included 561 patients with cervical radiculopathy and did not attempt to distinguish those with CDH. […] With regard to age, the Rochester study reported that the mean age of men with cervical radiculopathy was 47.6 and for women was 48.2. […] Of the 332 males and 229 females, ages 13-91, studied in that report, 21.9% had a confirmed disc protrusion. Other studies suggest that the types of cervical disc herniation presentations tend to be age specific and related to various habits or occupations such as those requiring heavy lifting or activities involving repeated axial loading.

• #15 Herniated disk: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000442.htm

  Herniated disks occur more often in middle-aged and older men, usually after strenuous activity. […] Other risk factors may include: lifting heavy objects, being overweight, repetitive bending or twisting the lower back or neck, sitting or standing in same position for long hours, inactive lifestyle, and smoking.

• #16 Herniated Disk in the Lower Back – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/

  A herniated disk (sometimes called a ruptured disk) is a condition that can occur anywhere along the spine, but most often occurs in the lower back. It is one of the most common causes of lower back pain, as well as leg pain, or sciatica. […] Between 60 and 80% of people will experience low back pain at some point in their lives. Some of these people will have low back pain and leg pain caused by a herniated disk. […] A herniated disk is most often the result of natural, age-related wear and tear on the spine. This process is called disk degeneration. […] In children and young adults, disks have high water content. As people age, the water content in the disks decreases and the disks become less flexible. The disks begin to shrink and the spaces between the vertebrae get narrower. This normal aging process makes the disks more prone to herniation. […] Certain factors may increase your risk of a herniated disk. These include: […] Gender. Men between the ages of 20 and 50 are most likely to have a herniated disk. […] There is up to a 20 to 25% chance that the disk will herniate again in your lifetime.

• #17 6 Facts About Lumbar Disk Herniation Everyone Needs to Know

  https://www.physiotutors.com/6-facts-every-healthcare-professional-needs-to-know-about-lumbar-disc-herniations/

  Herniations are broadly defined as localized or focal displacement of disc material beyond the limits of the intervertebral disc space. […] Its important to realize that disc protrusions are very common, also in healthy people. A famous study by Brinjikij et al. (2015) showed that almost one-third of healthy 20-year-olds have a disk protrusion. The numbers increase with age up to 43% at the age of 80, so almost every second person without low back pain has a herniated disk. […] Asymptomatic findings such as disk protrusion are so common that they can be considered gray hair from the inside. […] In a Chinese study, Zhang et al. (2009) report that family history and genetic predisposition was by far the biggest risk factor. […] An interesting literature review by Belavy et al. (2016) showed an increased risk for lumbar disc herniations in astronauts after return to earth. […] A meta-analysis from Zhong et al.(2017) confirms these findings showing that spontaneous resorption was reported in 66% of patients across eleven different studies.

• #18

  https://link.springer.com/article/10.1007/s00586-024-08528-8

  Incidence of LDH with radiculopathy varies by source population and case definition. […] The lower and upper bound limits of the 95% CIs of annual incidence estimates ranged from 0.3 to 2.7 per 1000 persons for surgical case definitions, from 0.04 to 1.5 per 1,000 persons for hospital-based case definitions, and from 0.1 to 298.3 per 1,000 persons for clinical case definitions. […] Our findings support the need to develop standardised case definitions that validly classify the clinical spectrum of LDH and for future low risk of bias studies examining causal relationships for LDH with radiculopathy in adults. […] We found evidence from low risk of bias phase III studies that mid-age (30-50 years), higher BMI and cardiovascular risk factors (in women), smoking, and greater cumulative occupational lumbar load by forward bending postures and manual materials handling are associated with the development of LDH with radiculopathy. […] The annual incidence of LDH with radiculopathy varies widely, reflecting the variability in evidence due to differences in case definitions and study populations.

• #19 Open Access Macedonian Journal of Medical Sciences (OAMJMS).

  https://oamjms.eu/index.php/mjms/article/view/8768

  Overall 342 patients with LBP came into Imagery department, the prevalence of lumbar disc herniation resulted 31.9% (109/342). […] The prevalence of LDH among patients with LBP resulted 31.9%, and men were more prone to suffered from disc herniation than women, due to increased mechanical stress and injury.

• #20 Cervical Disc Disease: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/305720-overview

  HNP may be observed with magnetic resonance imaging (MRI) in 10% of asymptomatic individuals aged younger than 40 years and 5% of those older than 40 years. […] Degenerative disc disease (DDD) may be observed with MRI in 25% of asymptomatic individuals aged less than 40 years and 60% of those aged more than 40 years. […] The true incidence and prevalence of cervical radiculopathy is uncertain; however, studies have shown that 51-67% of adults experience neck and arm pain at some time, and 54% report pain present within the last 6 months. […] In a population-based study in Rochester, Minn published in 1994 the annual incidence of documented cervical radiculopathy for men and women from all causes was 107.3 and 63.5 cases per 100,000 population, respectively. […] A separate study looking at a population at risk of more than 13,000,000 people in the military found an incidence of 1.79 per 1000 person-years.

• #21

  https://www.orthobullets.com/spine/2033/thoracic-disc-herniation

  Thoracic Disc Herniations are rare, causes of midline back pain and sensory changes around the rib cage. […] Incidence is relatively uncommon and makes up only 1% of all HNP. […] It is rare due to decrease motion of the thoracic spine and decreased disc height. […] Most commonly seen between 4th and 6th decades of life. […] Underlying Scheuermann’s disease may predispose to thoracic HNP.

• #22

  https://step1.medbullets.com/msk/112009/intervertebral-disk-herniation

  male:female ratio is approximately 2:1 […] peak incidence in 4th and 5th decades […] risk factors include manual labor, heavy lifting, and competitive sports […] incidence of cauda equina syndrome occurs in 1-10% of lumbar disc herniations.

• #23 Intradural disc herniation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/intradural-disc-herniation?lang=us

  Intradural disc herniations correspond to a rare presentation of a common pathology, comprising ~0.28% of all disc herniations. […] A higher incidence of cauda equina syndrome has been reported when compared to extradural hernias.

• #24 Herniated Lumbar Disk | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0401/p1240.html

  The natural history of disk herniation is difficult to determine because most persons receive some form of treatment for their back pain, and there is not always a formal diagnosis. Clinical improvement is usual in most persons, and only about 10 percent still have pain sufficient enough to consider surgery after six weeks. Sequential magnetic resonance images have shown that the herniated portion of the disk tends to regress over time, with partial to complete resolution after six months in two thirds of persons.

• #25 Epidemiological surveillance of lumbar disc surgery in the general population: A pilot study in a French region – EM consulte

  https://www.em-consulte.com/article/288512/epidemiological-surveillance-of-lumbar-disc-surger

  Epidemiological surveillance of lumbar disc surgery in the general population: A pilot study in a French region – 04/05/11 […] The aim of this pilot study was to assess the feasibility of a surveillance system for DRS using hospital databases for lumbar disc surgery (LDS). […] The surveillance of LDS can identify occupations and industries at risk.

• #26 Epidemiological surveillance of lumbar disc surgery in the general population: A pilot study in a French region – EM consulte

  https://www.em-consulte.com/es/article/288512/article/epidemiological-surveillance-of-lumbar-disc-surger

  Epidemiological surveillance of lumbar disc surgery in the general population: A pilot study in a French region – 04/05/11 […] Disc-related sciatica (DRS) is a significant and costly health problem in the working population. The aim of this pilot study was to assess the feasibility of a surveillance system for DRS using hospital databases for lumbar disc surgery (LDS). […] The surveillance of LDS can identify occupations and industries at risk.

• #27 Cervical disc herniation epidemiology [Neurosurgery Education Wiki]

  https://neurosurgery.education/wiki/doku.php?id=cervical_disc_herniation_epidemiology

  A significant number of asymptomatic disc herniation (DH) cases may be present as well. […] However, these results have been limited to a certain age group, region, occupation, or group and cannot be referred to when evaluating the occurrence distribution in all age groups or the differences in DH incidence between men and women according to age thereby limiting their generalizability. […] Generally, identifying the distribution of disease occurrence is crucial for preventing a disease and determining the association between occupational factors and disease occurrence in order to determine workers compensation. […] Therefore, in this study, we analyzed health insurance data to identify the distribution of symptomatic CDH and LDH occurrence according to age, sex, and workforce eligibility for national health insurance. […] Cervical disc herniation (CDH) is the most common cause of cervical radiculopathy and could overlap with fibromyalgia. The prevalences of FM and widespread pain in patients with CDH were found as 11.5% and 78.8% respectively.

• #28

  https://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2699

  Lumbar disc hernia represents one of the most frequent neurosurgical pathologies, consisting of a posterior migration of the nucleus pulposus which protrudes through the surrounding protective connective tissue. […] Regarding neuroimaging diagnosis, the gold standard of evaluation is Magnetic resonance imaging in different sequences which highlights a precise topography of the herniated disc. […] Currently, in a well-digitalized era, machine learning and deep learning algorithms are used to assess the sensibility of detecting a lumbar disc hernia, with promising results. […] In the actual neurosurgical management, postoperative complications following lumbar disc hernia surgery are rare and accessible to manage.

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