The Dose-Response Relationship Between Cumulative Lifting Load and Lumbar Disk Degeneration Based on Magnetic Resonance Imaging Findings

Hung, Isabella Yu-Ju; Shih, Tiffany Ting-Fang; Chen, Bang-Bin; Hwang, Yaw-Huei; Ma, Longfei; Huang, Wen-Chuan; Liou, Saou-Hsing; Ho, Ing-Kang; Guo, Yang

doi:10.2522/ptj.20130095

Cited by 24 publications

(60 citation statements)

References 37 publications

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“…They showed that male workers who had been exposed to cumulative lifting loads of 5 -21.5 ×10 6 Nh exhibited a 1.7-fold higher risk of disk protrusion compared to those exposed to loads of 0 -<5 ×10 6 Nh, suggesting that cumulative effects of all lifting loads, without a threshold, on disk protrusion [5][6][7]. In a later study [8], participants who had been exposed to a high lifting load (≥8.9 ×10 6 Nh) exhibited an OR of 2.2 for disk protrusion compared to those exposed to a low lifting load (<4.9 ×10 5 Nh). This last study also assumed no per lift threshold for the accumulated load.…”

Section: Discussionmentioning

confidence: 96%

The Roles of Lumbar load thresholds in lifetime cumulative lifting exposure to predict disk protrusion in an Asian Population

Hung

Shih

Chen

et al. 2020

Preprint

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Background: The purpose of this study was to determine whether a specific threshold per lifting movement, the accumulation above which best predicts lumbar disk protrusion, exists or the total lifting load should be considered. Methods: This was a retrospective study. Subjects with various lifting exposures were recruited. Disk protrusion was assessed by magnetic resonance imaging. The cumulative lifting load was defined as the sum of the time-weighed lumbar load for each job and was calculated using a biomechanical software system. The effectiveness of accumulation above different thresholds in predicting disk protrusion were compared using four statistical methods. Results: A total of 252 men and 301 women were included in the final analysis. For the men, 3000 Newtons for each lifting task was the optimal threshold for predicting L4-S1 disk protrusion, whereas for the women, 2800 Newtons was optimal. Conclusions Our findings suggested that for cumulative lifting exposure, including the total lifting load without defining a minimal exposure limit might not be the optimal method for predicting disk protrusion. The NIOSH 3400 Newton recommended limits do not appear to be the optimal thresholds for preventing disk protrusion. Different lifting thresholds might be needed for men and women in the workplace for their safety. Keywords: Cumulative, Lifting load, Cross-sectional study, Threshold, Disk protrusion

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Section: Discussionmentioning

confidence: 96%

The Roles of Lumbar load thresholds in lifetime cumulative lifting exposure to predict disk protrusion in an Asian Population

Hung

Shih

Chen

et al. 2020

Preprint

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“…The most surprising outcome of this study is probably that strong evidence was found that age, gender, body weight, BMI, smoking, car driving, the type of occupation (ie, working as a nurse or construction carpenter) nor recreational activities at leisure time were associated with the progression of DD. This was unexpected, as several studies show that heavy physical activity or work and smoking are key factors in the onset of DD . For smoking, however, there is one high‐quality study (out of five) that finds that smoking during follow‐up to a greater reduction in disc height .…”

Section: Discussionmentioning

confidence: 99%

“…show that heavy physical activity or work and smoking are key factors in the onset of DD. 11,[54][55][56] For smoking, however, there is one highquality study (out of five) that finds that smoking during follow-up to a greater reduction in disc height. 42 This is in contrast to a study by the same authors 2 years earlier, in which they found that smoking did not have any effect on the change in degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Many initiating factors have been identified that can push the intervertebral disc into the vicious cycle of degeneration, such as mechanical overloading by heavy physical workload or systemic inflammatory disorders like diabetes, but the factors that encourage this downward spiral are less addressed, nor is there an overview of these prognostic factors present in literature. A prognostic factor is a clinical or biological aspect that is objectively measurable and that provides information on the possible course of the condition in an untreated patient .…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] The exact pathophysiology of DD is not yet completely understood, but it often starts at a quite young age with an imbalance in the interplay of biomechanics, cell behavior, and extracellular matrix, ending up in a cascade of degeneration. 8 Many initiating factors have been identified that can push the intervertebral disc into the vicious cycle of degeneration, such as mechanical overloading by heavy physical workload or systemic inflammatory disorders like diabetes, [9][10][11][12][13][14] but the factors that encourage this downward spiral are less addressed, nor is there an overview of these prognostic factors present in literature. A prognostic factor is a clinical or biological aspect that is objectively measurable and that provides information on the possible course of the condition in an untreated patient.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors in the progression of intervertebral disc degeneration: Which patient should be targeted with regenerative therapies?

et al. 2019

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Objective Possible regenerative treatments for lumbar intervertebral disc degeneration (DD) are rapidly emerging. There is consensus that the patient that would benefit most has early‐stage DD, with a predicted deterioration in the near future. To identify this patient, the aim of this study was to identify prognostic factors for progression of DD. Study design Systematic review. Methods A systematic search was performed on studies evaluating one or more prognostic factor(s) in the progression of DD. The criteria for inclusion were (a) patients diagnosed with DD on MRI, (b) progression of DD at follow‐up, and (c) reporting of one or more prognostic factor(s) in progression of DD. Two authors independently assessed the methodological quality of the included studies. Due to heterogeneity in DD determinants and outcomes, only a best‐evidence synthesis could be conducted. Results The search generated 3165 references, of which 16 studies met our inclusion criteria, involving 2.423 patients. Within these, a total of 23 clinical and environmental and 12 imaging factors were identified. There was strong evidence that disc herniation at baseline is associated with progression of DD at follow‐up. There is limited evidence that IL6 rs1800795 genotype G/C male was associated with no progression of DD. Some clinical or environmental factors such as BMI, occupation and smoking were not associated with progression. Conclusions Disc herniation is strongly associated with the progression of DD. Surprisingly, there was strong evidence that smoking, occupation, and several other factors were not associated with the progression of DD. Only one genetic variant may have a protective effect on progression, otherwise there was conflicting or only limited evidence for most prognostic factors. Future research into these prognostic factors with conflicting and limited evidence is not only needed to determine which patients should be targeted by regenerative therapies, but will also contribute to spinal phenotyping.

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IL‐17 in intervertebral disc degeneration: Mechanistic insights and therapeutic implications

Tan

Liu

et al. 2022

Cell Biology International

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The Dose-Response Relationship Between Cumulative Lifting Load and Lumbar Disk Degeneration Based on Magnetic Resonance Imaging Findings

Abstract: The results suggest a dose-response relationship between cumulative lifting load and LDD.

Cited by 24 publications

References 37 publications

The Roles of Lumbar load thresholds in lifetime cumulative lifting exposure to predict disk protrusion in an Asian Population

The Roles of Lumbar load thresholds in lifetime cumulative lifting exposure to predict disk protrusion in an Asian Population

Prognostic factors in the progression of intervertebral disc degeneration: Which patient should be targeted with regenerative therapies?

IL‐17 in intervertebral disc degeneration: Mechanistic insights and therapeutic implications

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