Methodology and cohort profile for the Hangzhou Lumbar Spine Study: a study focusing on back health in a Chinese population

Abstract

Back pain is a worldwide health problem, adding a tremendous burden to modern societies. However, little information on back health is available in China, even though a quarter of the world's population is Chinese. To enhance knowledge in this area, we designed and initiated the Hangzhou Lumbar Spine Study, which is a cross-sectional study of a general sample of mainland Chinese with focusing on disc degeneration, Modic changes, endplate lesions, and back pain. The study consists of a structured questionnaire to measure back pain history and lifetime exposure to suspected risk factors, magnetic resonance imaging of the lumbar spine, bone mineral density study of the spine and hip, and DNA sample analysis. Here we briefly introduce the study methodology, report the test-retest reliability of the questionnaire, and describe the cohort profile to date. Since May 2014, 301 randomly selected subjects (male/female, 122/179; mean age, 51.0 years; range, 20-87 years) have been recruited. Tests-retests of the questionnaire, completed by 40 participants, revealed good reliability. To our knowledge, the Hangzhou Lumbar Spine Study is the first population-based epidemiological study conducted to characterize lumbar spinal phenotypes and back pain, their interaction, and their associations with lifetime environmental exposure, in mainland Chinese. Epidemiological information obtained from a reliable questionnaire, magnetic resonance (MR) imaging data, dual energy X-ray absorptiometry (DXA) measurements, and DNA analysis may serve as a valuable reference for future studies on back health, particularly for mainland Chinese.

The lumbar spinal endplate lesions grades and association with lumbar disc disorders, and lumbar bone mineral density in a middle-young general Chinese population

“…In 2018, two common and certified nomenclature systems for endplate lesions had been almost recommended simultaneously by Brayda-Bruno [ 4 ] and Feng [ 8 ], respectively. Although Wang’s team contributed to the lumbar spine study both in vivo and cadaveric spines for many years [ 19 , 24 ], Feng et. al considers that the different types of endplate defects differed in morphology, distribution patterns, and strength of association with disc degeneration, suggesting they represent different pathologies [ 8 ].…”

Lumbar disc herniation in juveniles: A case–control study of MRI characteristics and etiological insights

“…Body mass index (BMI) was calculated and each participant was classified as underweight, normal, overweight, or obese 25 . The participant was asked about involvement in physical labor work, which was classified as on a progressive 4‐point scale, 26 as was daily sitting hours. Regular exercise beyond basic physical education class during schooling was recorded.…”

“…To be considered, a reported back injury incident had to occur within 1 month before the onset of back‐related symptoms 29 . Most items in the study questionnaire were adapted from previously published studies, which were with reasonable validity and reliability 25–29 …”

The lumbar spinal endplate lesions grades and association with lumbar disc disorders, and lumbar bone mineral density in a healthy Chinese cohort

“…In 2018, two common and certi ed nomenclature systems for endplate lesions had been almost recommended simultaneously by Brayda-Bruno [5] and Feng [9], respectively. Although Wang's team contributed to the lumbar spine study both in vivo and cadaveric spines for many years [20,25], Feng et. al considers that the different types of endplate defects differed in morphology, distribution patterns, and strength of association with disc degeneration, suggesting they represent different pathologies [9].…”