Study Design. Epidemiological study. Objective. To investigate the incidence and risk factors for developing low back pain in active duty military population to include age, sex, race, and rank, and military service. Summary of Background Data. Low back pain is among the most common musculoskeletal conditions worldwide and is estimated to affect nearly two-thirds of the US population at some point in their lives. Low back pain is a multifactorial disease and many risk factors have been implicated including age, race, sex, and marital status. Methods. A query was performed using the US Defense Medical Epidemiology Database (DMED) for the International Classifi cation of Diseases, Ninth Revision, Clinical Modifi cation code for low back pain (724.20). 13,754,261 person-years of data were investigated. Multivariate Poisson regression analysis was used to estimate the rate of low back pain per 1000 person-years, whereas controlling for sex, race, rank, service, age, and marital status. Results. The overall unadjusted incidence rate of low back pain was 40.5 per 1000 person-years. Women, compared with men, had a signifi cantly increased incidence rate ratio for low back pain of 1.45. The incidence rate ratio for the 40 + age group compared with the 20 to 29 years of age group was 1.28. With junior offi cers as the referent category, junior-and senior-enlisted rank groups had increased incidence rate ratio for low back pain, 1.95 and 1.35, respectively. Each service, when compared with the Marines as the referent category, had a signifi cantly increased incidence rate L ow back pain is among the most common musculoskeletal conditions worldwide and is estimated to affect up to 85% of the US population at some point in their lives. It is a signifi cant cause of disability in the working population and carries a substantial economic impact with an estimated annual cost of $28 billion in the United States alone.2 , 3 Because of the impact it has on a signifi cant portion of the general population, it has been the subject of numerous studies to identify populations at greater risk as well as factors that contribute to the development of this condition.Although low back pain is such a common condition, it remains poorly understood. It is a complex and multifactorial condition with many contributing variables to include psychosocial factors 4 -6 The US Armed Forces represents a physically active population of male and female service members with generally high occupational demands. These patients are also screened at the initial military entry examination for preexisting spinal conditions. Findings of any preexisting spinal abnormalities exclude patients from entry to active duty military service. Once in military service, these patients must meet the standards of a semiannual physical fi tness test and height/weight requirements and must also participate in organized physical fi tness training programs. The purpose of our study is to evaluate the incidence and demographic risk factors associated with new onset low back pa...

PurposeTo characterize the epidemiology and costs associated with spinal cord injury without radiographic abnormality (SCIWORA) based on patient age.MethodsAn analysis of data complied for 2012 in the Healthcare Utilization Project KID database (HCUP-KID), which represents a nationwide database of pediatric admissions, was performed. An initial search identified all children diagnosed with SCIWORA based on International Classification of Diseases, 9th edition (ICD-9) codes. Only data on patients aged <18 years were included in the analysis. The associated codes were then searched to identify the cause of injury. Pertinent epidemiologic data were collected from the database, including age, gender, and racial group. Injury level and pattern were determined from the associated ICD-9 codes, as were associated injuries. Hospital data included length of stay, in-hospital mortality, total hospital charges, and primary payer. All data were compiled and stratified based on patient age into three groups: group 1, age 0–3 years; group 2, age 4–10 years; group 3, age 11–17 years. These data were compared using Student’s t test and Chi-squared analyses.ResultsA total of 297 patients were identified who met the inclusion criteria. There was a slight predominance of females among the youngest patients (53 %) with a significant dominance of males in the oldest group (72 %) (p < 0.001). The most common race among the patients studied was white (50 %) followed by Hispanic (14 %), Black (12 %), Asian/Pacific Islander (4 %), and Native American (1 %). Overall, the most common cause of injury was sports injuries, which were responsible for 122/297 (41 %) injuries, followed by motor vehicle collisions (26 %). Mechanisms of injury were significantly varied based on age group, with motor vehicle collisions the most common cause in the youngest two age groups and sports injuries the most common in the oldest age group (p < 0.05). The most common location injured was the cervical spine (46 %), with the upper cervical spine most commonly injured, particularly in the younger age groups. Additional injuries were found in 158/297 (53 %) of patients, and these were more common among younger patients. Head trauma was the most common associated injury in all age groups, but the highest rate was found the youngest age groups (p < 0.0001). The average hospital stay for all patients was 13 days, with longer stays seen in younger age groups (p < 0.05). In-hospital mortality was uncommon among these patients and occurred in only 6/297 (2 %) of patients. Hospital charges were highest in the younger age groups, with an average charge of $210,772 for those in the youngest age group, decreasing to $72,178 for those in group 3 (p < 0.0005). The most common payer was public insurance/medicaid in the youngest age group and private insurance in groups 2 and 3 (p < 0.0001).ConclusionsSCIWORA is an uncommon but potentially devastating injury in children. As with many pediatric injuries, this injury is heterogeneous between children of differing ages. This anal...

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Although much research has been performed on occupational risk factors for low back pain, little has been published on low back pain among infantrymen. This purpose of this study is to evaluate the incidence of acute low back pain amongst active duty infantrymen as compared to a matched control population. The Defense Medical Epidemiology Database was searched and incidence rates were calculated and compared between infantry and noninfantry soldiers. Data was stratified and controlled for age, race, marital status, rank, and branch of service using the Poisson multivariate regression analysis. Significantly lower rates of acute low back pain were discovered in active duty infantrymen when compared to matched controls (32.9 versus 49.5 cases per 1,000 person-years). Additionally, significantly lower rates were identified in the Marines versus the Army, and among junior enlisted compared to senior enlisted service members.