A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders

Abstract

ObjectiveThe purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders.MethodsA scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities.ResultsOf 3,453 candidate papers, 145 met study criteria and were included in this review. Risk factors were reported for group 1: non-specific low back pain (smoking, overweight/obesity, negative recovery expectations), non-specific neck pain (high job demands, monotonous work); group 2: degenerative spinal disease (workers’ compensation claim, degenerative scoliosis), and group 3: spinal tuberculosis (age, imprisonment, previous history of tuberculosis), spinal cord injury (age, accidental injury), vertebral fracture from osteoporosis (type 1 diabetes, certain medications, smoking), and neural tube defects (folic acid deficit, anti-convulsant medications, chlorine, influenza, maternal obesity). A range of comorbidities was identified for spinal disorders.ConclusionMany associated factors for common spinal disorders identified in this study are modifiable. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely comorbid versus ones that are risk factors. Modifiable risk factors present opportunities for policy, research, and public health prevention efforts on both the individual patient and community levels. Further research into prevention interventions for spinal disorders is needed to address this gap in the literature.

The Global Spine Care Initiative: methodology, contributors, and disclosures

“…We have done our best to address many of the concerns and comments regarding the development of recommendations [21][22][23][24][25]. The GSCI author team attempted to balance potential biases as much as possible during the deliberations, paper development, and in the determination of recommendations [7][8][9][10][11][12][13][14][15][16][17][18][19][20]26]. Participants were asked to declare any potential conflicts.…”

The Global Spine Care Initiative: classification system for spine-related concerns

“…Clinicians in general practice see people with minor symptoms or concerns who either may seek advice for prevention or may be seeking care for another complaint. It was recommended that any model of care should include guidance on current evidence as defined in the GSCI papers concerning prevention including risk factors, comorbidities, and the importance of psychosocial concerns that could lead to over-medicalization [24][25][26][27][28][29][30]. Primary and secondary prevention measures, whether applied at a population or individual level, could potentially reduce further the burden of spine disorders when applied to the specific needs of any given community [28,30].…”

“…It was recommended that any model of care should include guidance on current evidence as defined in the GSCI papers concerning prevention including risk factors, comorbidities, and the importance of psychosocial concerns that could lead to over-medicalization [24][25][26][27][28][29][30]. Primary and secondary prevention measures, whether applied at a population or individual level, could potentially reduce further the burden of spine disorders when applied to the specific needs of any given community [28,30]. These goals are consistent with WHO global strategy on integrated people-centered health services 2016-2026 that state "Reorienting the model of care … requires investment in holistic and comprehensive care, including health promotion and ill-health prevention strategies that support people's health and well-being."…”

Prevalence of Musculoskeletal Disorders Symptoms Among Czech Dental Students. Part 2: The Predictive Value of Digital Assessment

“…The relationship between the spinal curve and the development of MSD is not clear. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely co-morbid versus ones that are risk factors (15). It seems that postural defects in the sagittal plane may predict the prevalence of pain with a higher prevalence of pain in people with a higher angle of lumbar lordosis (16).…”