Materiały źródłowe

• #1

  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.

• #1 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.

• #2 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.

• #3 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.

• #4 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. […] 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.

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

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

  Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. Approximately 515% of patients with low back pain suffer from lumbar disc herniation. […] 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. […] The lumbar discs most often affected and leads to herniation are L3-L4, and L4L5.

• #6 (PDF) Epidemiology of lumbar disc herniations in adults with low back pain in Enugu, Nigeria

  https://www.academia.edu/60874388/Epidemiology_of_lumbar_disc_herniations_in_adults_with_low_back_pain_in_Enugu_Nigeria

  Background: Lumbar intervertebral disc herniation is used to describe a spectrum of anatomical abnormalities involving disc extension beyond the interspace. It follows a tear in the annulus fibrosus of the intervertebral disc. It is one of the most common causes of low back pain among adults. The study aims to assess the epidemiological pattern of lumbar disc herniations among adults with low back pain in Enugu urban. […] There are multiple risk factors for lumbar disk hernia regarding a combination of genetics and acquired characteristics and lifestyle. […] The most common cause of lumbar radiculopathy is lumbar disc herniation (LDH). […] Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. Approximately 515% of patients with low back pain suffer from lumbar disc herniation.

• #7

  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. […] 3:1 male:female ratio. […] L5/S1 most common level. […] 95% involve L4/5 or L5/S1 levels.

• #8

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

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

• #9 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. Many guidelines and consensus for the diagnosis and treatment of LDH have been published domestically and internationally. […] According to the expert consensus, clinicians could adopt tailored and personalized diagnosis and treatment management strategies for LDH patients. […] LDH is a frequent and common disease that majorly affected adults in the clinical context. At least 95% of LDH occurs in L4-5 and L5-S1. 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%.

• #10

  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. […] Diagnosis is made with MRI studies of the thoracic spine. […] Treatment is usually activity modification, physical therapy, and pain management. Surgical management is indicated in patients with persistent pain or progressive neurological symptoms. […] Epidemiology: Incidence: relatively uncommon and makes up only 1% of all HNP. […] rare due to decrease motion of the thoracic spine and decreased disc height. […] Demographics: most commonly seen between 4th and 6th decades of life. […] as the disc desiccates it is less likely to actually herniate. […] Anatomic location: usually involves middle to lower levels. […] T11-T12 most common level. […] 75% of all thoracic disc herniations occur between T8 and T12. […] Risk factors: underlying Scheuermann’s disease may predispose to thoracic HNP.

• #11 Lumbar disc lesion: Study of epidemiology and surgical intervention

  https://www.orthopaper.com/archives/2020.v6.i3.2233/lumbar-disc-lesion-study-of-epidemiology-and-surgical-intervention

  As per European studies 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 the fifth decade of life, with a male to female ratio of 2:1. […] Epidemiology of lumbar disc disease among Indian population needing operative intervention is not clear. […] To study the Epidemiology of lumbar disc disease among Indian population needing operative intervention. […] The more common age group affected was 40 to 60 years age group (53.33%). Gender distribution has a male predominance (73.33%) compare to females (26.66%). […] Majority having L4-L5 disc involvement (70%). […] Out of 120 patients 30 (25%) patients needed operative intervention and rest were managed by conservative line of management. Majorly affect 40 to 60 years age group with mean of 44.9 years males outnumbering females in incidence with majority involving L4-L5 disc level.

• #12 Lumbar Disc Lesions – Illinois Chiropractic Society

  https://ilchiro.org/lumbar-disc-lesions/

  Lumbar disc lesion describes the undesirable midpoint on a continuum of problems, beginning with repetitive disc sprain, leading to herniation, ending in degeneration. Multiple factors contribute to the development of lumbar disc lesions (LDL). Repetitive mechanical stressors like compressive loading, shear stress, and vibration weaken annular fibers, eventually leading to disruption. Only the outermost annular lamellae are innervated, so early disruption may be asymptomatic. […] Since the posterolateral annulus is the weakest point of the disc, most disc lesions occur in this region (1). The posterior longitudinal ligament (PLL) tapers caudally, and over 90% of disc lesions occur at L4/5 or L5/S1, with the latter being most prevalent (6). The lumbopelvic bony architecture may have a predictive effect on the level of LDH- in that patients with long L5 transverse processes and/or high intercrestal lines (horizontal line drawn between the tops of the iliac crests) have a significantly higher incidence of L4/5 disk herniation, whereas low intercrestal lines and lumbarization are associated with L5/S1 disk herniation. (33)

• #12 Lumbar Disc Lesions – Illinois Chiropractic Society

  https://ilchiro.org/lumbar-disc-lesions/

  Approximately 35-45% of adults will experience lumbar disc lesions at some point in their lifetime and the condition is more common in men (5). […] The clinical presentation for lumbar disc lesions is dependent upon the degree of neurologic involvement. Asymptomatic disc herniations are present in 20-36% of the adult population (7). […] The differential diagnosis for lumbar disc lesions includes infection, tumor, fracture, spondylosis, peripheral neuropathy, piriformis syndrome, hip or knee pathology, and herpes zoster. The presence of cauda equina symptoms (saddle numbness or paresthesia, incontinence, difficulty with urination, impotence, bilateral radicular signs or symptoms) is a medical emergency requiring immediate medical attention. […] A systematic review showed no significant long-term effect for surgery compared to physical activity based interventions for leg and back pain from lumbar disc herniation. (39)

• #13

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

  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. […] Understanding these relationships is vital for developing effective prevention strategies and guiding clinical practices to mitigate the incidence and impact of LDH with radiculopathy.

• #13

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

  Lumbar disc herniation (LDH) with radiculopathy is associated with greater pain, disability, healthcare use, and costs compared with nonspecific low back pain. […] Reliable information about its incidence and risk factors were lacking. […] 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. […] Factors associated with the development of LDH with radiculopathy included middle-age (30-50 years), smoking, higher BMI, presence of cardiovascular risk factors (in women), and greater cumulative occupational lumbar load by forward bending postures and manual materials handling, with effect sizes ranging from ranging from 1.1 (1.0-1.3) to 3.7 (2.3-6.0).

• #13

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

  Incidence of LDH varies in different populations and according to case definition. […] Risk factors include individual, behavioural, and work-related variables. […] 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. […] The incidence of LDH with radiculopathy varied by source population and case definition. […] Annual incidence estimates for hospitalised or surgically managed LDH ranged between 0.2 to 1.3 per 1,000 persons among the general population. […] The annual incidence of LDH with radiculopathy defined based on clinical signs and symptoms varied from 2.8 per 1,000 persons (0.3%) among healthcare professionals in Taiwan, to 218 per 1,000 persons (22%) among male earthmoving machine drivers in Italy.

• #14 Lumbar Disc Disorders | PM&R KnowledgeNow

  https://now.aapmr.org/lumbar-disc-disorders/

  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. No difference related to gender has been determined. […] Correlations have been found with body mass index, mechanical loading, and genetic predisposition. […] Smoking and increased rates of disk degeneration, with animal models showing increased proinflammatory markers, alterations to annular structure, vasoconstriction, and altered nutrient distribution to the disk.

• #15 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/

  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 consideren 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. This was followed by lumbar load at work and strenuous work, while regular physical exercise and sleeping on a hard bed were both protective. Furthermore, a study on Swedish construction workers (Wahlstrm et al. 2012) and two systematic reviews with meta-analysis revealed that smoking (Huang et al. 2016), obesity and overweight (Shiri et al. 2014) as well as being taller than 1 meter 90 or 6 foot 3 are further risk factors.

• #16 Epidemiology of Lumbar Disc Degeneration | Musculoskeletal Key

  https://musculoskeletalkey.com/epidemiology-of-lumbar-disc-degeneration/

  Evidence from both experimental and clinical observations support that clear trauma is a risk factor for disc degeneration. One animal model of disc degeneration involves surgically producing a peripheral annular lesion, which quickly leads to degenerative changes in the disc (Osti et al. 1990). A recent clinical study observed a similar, although less dramatic, causal association between injury to the annulus fibrosus and disc degeneration related to needle puncture in discography. Greater disc degeneration was observed in the non-degenerated or healthy discs following discography over a 10-year follow-up (Carragee et al. 2009). […] Cigarette smoking is the only chemical exposure known to associate with lumbar disc degeneration. While it is commonly accepted that smoking has deleterious effects on the disc and research has turned to understanding the mechanisms involved (Vo et al. 2011), it is important to keep in mind that the effects are likely to be very modest. Using identical twins grossly discordant for smoking exposure (over 32 pack-years), the overall disc degeneration across the entire lumbar spine was greater in smokers as compared to their nonsmoker siblings. Yet, the effect size was very small, explaining less than 2 % of the variance in degeneration scores (Battie et al. 1991).

• #16 Epidemiology of Lumbar Disc Degeneration | Musculoskeletal Key

  https://musculoskeletalkey.com/epidemiology-of-lumbar-disc-degeneration/

  Before the mid- to late 1990s, the dominant model of the etiology of disc degeneration was one of repetitive loading or wear and tear. This paradigm generally viewed disc degeneration as a consequence of repeated loading and associated tissue insults and injuries. Correspondingly, behavioral and environmental factors, such as occupational materials handling, were viewed as the main causes of disc degeneration. Not surprisingly, these influences were the focus of research and prevention strategies. Based on knowledge of that time, Frymoyer summarized the findings of epidemiological studies on degenerative disc disease by stating Among the factors associated with its occurrence are age, gender, occupation, cigarette smoking, and exposure to vehicular vibration. The contribution of other factors such as height, weight, and genetics is less certain (Frymoyer 1992). A decade later, a major shift in views was underway. Taking into account new knowledge gained from the intervening decade, in 2002 Ala-Kokko concluded that Even though several environmental and constitutional risk factors have been implicated in this disease, their effects are relatively minor, and recent family and twin studies have suggested that sciatica, disc herniation and disc degeneration may be explained to a large degree by genetic factors (Ala-Kokko 2002). Disc degeneration is now considered a condition that is largely genetically influenced, with environmental factors, although elusive, also playing an important role (Battie et al. 2009).

• #17

  https://journals.lww.com/spinejournal/fulltext/2004/12010/lumbar_disc_degeneration__epidemiology_and_genetic.12.aspx

  There are extreme variations in the reported prevalence of specific degenerative findings of the lumbar spine among studies, which cannot be explained entirely by age or other identifiable risk factors (e.g., prevalence figures for disc narrowing varied from 3% to 56%). […] The article reviews the epidemiology of lumbar disc degeneration, including what is known of its prevalence and factors associated with its occurrence. […] Recent research indicates that heredity has a dominant role in disc degeneration, explaining 74% of the variance in adult populations studied to date. […] The role of genetic influences is a dominant feature of this shift.

• #18 Lumbar Degenerative Disk Disease: Background, Functional Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/309767-overview

  Globally, the prevalence of LBP was reportedly 619 million in 2020, with that figure projected to reach 843 million by 2050. However, for persons with LBP, the worldwide, age-standardized rates of prevalence and years living with disability (YLDs) had, between 1990 and 2020, fallen by 10.4% and 10.5%, respectively, the YLDs for 2020 being 832 per 100,000. […] The natural history of LBP has been reported to be favorable in some studies and is frequently quoted to patients. Reports indicate that 40-50% of patients are symptom-free within 1 week and that up to 90% of symptoms resolve without medical attention in 6-12 weeks. […] Deyo and Tsui-Wu reported that 33.2% of patients with LBP reported symptoms for less than 1 month, 33% reported pain for 1-5 months, and 32.7% reported pain for longer than 6 months.

• #18 Lumbar Degenerative Disk Disease: Background, Functional Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/309767-overview

  Later, over a 2-year follow-up, 44% of patients reported chronic symptoms (defined as back pain for 90 d in the previous 6 mo). […] Most patients had low levels of back pain, with 20% rating their pain at 4 or greater on a scale of 0-10 (where 0 indicates no pain), 13% rated their pain as 5 or greater, and 8% reporting pain of 6 or greater. […] Von Korff and colleagues reported that 15-20% of primary care patients with LBP had moderate-to-severe limitations in activity during a 1-year follow-up after their initial episode resolved. […] Recurrence rates of 60-85% have been reported in the first 2 years after an acute episode of LBP. […] LBP secondary to degenerative disk disease affects men and women equally. […] Gautschi et al found in a cohort of 214 patients with LDDD that preoperatively, females scored worse than males on measurement of subjective functional impairment but that males and females scored similarly in terms of objective functional impairment.

• #19 3 Telltale Signs You Have a Slipped or Bulging Disc

  https://www.spine-health.com/blog/3-telltale-signs-you-have-slipped-or-bulging-disc

  The discs in your lower back typically herniate or bulge in the posterior (back) and/or lateral (side) region, which is in close proximity to your spinal nerve roots. Herniated discs may affect these nerve roots through one or both of the following 2 methods: […] Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2. […] This condition can be very painful, but for most people, the symptoms dont last too long. Nearly 90% of people who experience painful lumbar disc herniation report within 6 weeks that they no longer feel the pain, even if they received no medical treatment for it. […] If you experience any difficulty in controlling your bowel and/or bladder movements, numbness in your inner thigh and genital area, and/or problems in starting urination, consult your doctor immediately. These symptoms and signs may indicate cauda equina syndrome, a serious medical emergency, which is possible with certain severe lower back disc herniations.

• #20 Lumbar disc syndrome in Finland. | Journal of Epidemiology & Community Health

  https://jech.bmj.com/content/41/3/251

  The prevalence of lumbar disc syndrome (herniated disc or typical sciatica) and its consequences in terms of disability, handicap, and need for medical care were studied as part of the Mini-Finland Health Survey. A diagnosis of lumbar disc syndrome based on medical history, symptoms, and standardised physical examination was made for 5.1% of the men and for 3.7% of the women. […] About 6% of the population’s work disability was estimated to be attributable to lumbar disc syndrome.

• #21 An epidemiological surveillance network of lumbar disc surgery to help prevention of and compensation for low back pain

  https://www.santepubliquefrance.fr/notices/an-epidemiological-surveillance-network-of-lumbar-disc-surgery-to-help-prevention-of-and-compensation-for-low-back-pain

  Background: in the context of the establishment of a new surveillance system, the aim was to assess the proportion of cases of lumbar disc surgery (LDS) attributable to work according to occupation category and industry sector. […] The AFE and PAF are valuable for public policy. Although PAF could be used to help public health policy makers to implement preventive measures, the AFE could assist expert tribunals who take decisions about compensation for occupational diseases.

• #22 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.

• #23 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 […] 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 risk of LDS varied according to occupations and industries. […] The surveillance of LDS can identify occupations and industries at risk.

• #24

  https://journals.lww.com/jbjsjournal/fulltext/2006/04002/lumbar_disc_degeneration__epidemiology_and.2.aspx

  Research into disc degeneration and genetics has become more limited by phenotypes or definitions and measures of disc degeneration than by DNA analysis. […] A review of the epidemiology of disc degeneration reveals wide-ranging prevalence estimates for various signs of disc degeneration in samples of the general population and in patients with back symptoms. […] The extreme variations in prevalence rates are likely largely due to inconsistencies in the definitions and measurements of disc degeneration. Such inconsistencies and inaccuracies impede epidemiologic research on disc degeneration.

• #25 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.

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