Advertisement

Etiopathogenesis

  • F. Postacchini
  • G. Cinotti

Abstract

The frequency of a disease in a given population, or morbosity, is the ratio between the number of patients suffering from that condition and healthy subjects. The morbosity of a disease is calculated on the basis of its prevalence and incidence. Prevalence is estimated by cross-sectional studies, in which the frequency of the condition and related risk factors are evaluated only once. It, thus, represents the number of patients presenting a disease at the time of investigation. Incidence, instead, is assessed by longitudinal studies, in which the frequency of the condition is evaluated at two different times. Therefore, it represents the number of new cases of a condition occurring during a certain time interval. Assessment of the prevalence is less expensive and time-consuming than the evaluation of the incidence. However, the prevalence of a condition may not accurately reflect its frequency since it is affected by the duration of the disease. For instance, in patients with lumbar disc herniation, in whom periods with radicular symptoms may be alternated with painless periods, the assessment of the prevalence may lead to underestimation of the morbosity of the condition.

Keywords

Intervertebral Disc Nucleus Pulposus Disc Herniation Disc Degeneration Lumbar Disc 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Adams M. A., Hutton W. C.: Prolapsed intervertebral disc. A hyperflexion injury. Spine 7: 184–191, 1982.PubMedGoogle Scholar
  2. 2.
    Adams M. A., Hutton W. C.: The effect of fatigue on the lumbar intervertebral disc. J. Bone Joint Surg. 65-B: 199–203, 1983.Google Scholar
  3. 3.
    Adams M. A., Hutton W. C.: Gradual disc prolapse. Spine 10: 524–531, 1985.PubMedGoogle Scholar
  4. 4.
    Ahmed A. M., Duncan N. L., Burke D. L.: The effect of facet geometry on the axial torque-rotation response of lumbar motion segments. Spine 15: 391–401, 1990.PubMedGoogle Scholar
  5. 5.
    An H. S., Silveri C. P., Simpson M. J. et al.: Comparison of smoking habits between patients with surgically confirmed herniated lumbar and cervical disc disease and controls. J. Spinal Disord. 7: 369–373, 1994.PubMedGoogle Scholar
  6. 6.
    Anderson P., Pedersen O. F., Bach B. et al.: Serum antibodies and immunoglobulins in smokers and non-smokers. Clin. Exp. Immunol. 47: 467–473, 1982.Google Scholar
  7. 7.
    Andersson G. B. J.: The epidemiology of spinal disorders. In: The adult spine. Principles and practice. Frymoyer J. W. Editor-in-Chief, Raven Press, New York, 1991.Google Scholar
  8. 8.
    Andersson G. B. J., Ortengren R., Nachmenson A. L. et al.: The sitting posture: an electromyographic and discometric study. Orthop. Clin. North Am. 6: 105, 1975.PubMedGoogle Scholar
  9. 9.
    Bahna S. I., Fleiner D. C., Myhre B. A.: Immunoglobulin E pattern in cigarette smokers. Allergy 38: 57–64, 1983.PubMedGoogle Scholar
  10. 10.
    Battiè M. C., Videman T., Gill K. et al.: Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine 16: 1015–1021, 1991.PubMedGoogle Scholar
  11. 11.
    Ben R. T., Wood P. H. N.: Pain in the back: an attempt to estimate the size of the problem. Rheumatol. Rehabil. 14: 121–128, 1975.Google Scholar
  12. 12.
    Betsch D. F., Baer E.: Structure and mechanical properties of rat tail tendon. Biorheology 17: 83–94, 1980.PubMedGoogle Scholar
  13. 13.
    Bobechko W. P., Hirsch C.: Autoimmune response to nucleus pulposus in the rabbits. J. Bone Joint Surg. 47-B: 574–580, 1965.Google Scholar
  14. 14.
    Brennan G. P., Ruhling R. O., Hood R. S. et al.: Physical characteristics of patients with herniated intervertebral lumbar disc. Spine 12: 699–702, 1987.PubMedGoogle Scholar
  15. 15.
    Brinckmann P., Porter R. W.: A laboratory model of lumbar disc protrusion. Fissure and fragment. Spine 19: 228–235, 1994.PubMedGoogle Scholar
  16. 16.
    DeOrio J. K., Bianco A. J. Jr.: Lumbar disc excision in children and adolescents. J. Bone Joint Surg. 64-A: 991–996, 1982.Google Scholar
  17. 17.
    Deyo R. A., Tsui-Wu Y.-J.: Descriptive epidemiology of low back pain and its related medical care in United States. Spine 12: 264–268, 1987.PubMedGoogle Scholar
  18. 18.
    Duncan N. D., Ahmed A. M.: The role of axial rotation in the etiology of unilateral disc prolapse. An experimental and finite-element analysis. Spine 16: 1089–1098, 1991.PubMedGoogle Scholar
  19. 19.
    Eckert C., Decker A.: Pathological studies of intervertebral discs. J. Bone Joint Surg. 29: 447–454, 1947.PubMedGoogle Scholar
  20. 20.
    Epstein J. A., Epstein N. E., Marc J. et al.: Lumbar intervertebral disc herniation in teenage children: recognition and management of associated anomalies. Spine 9: 427–432, 1984.PubMedGoogle Scholar
  21. 21.
    Evans W., Jobe W., Seibert C.: A cross-sectional prevalence study of lumbar disc degeneration in a working population. Spine 14: 60–64, 1989.PubMedGoogle Scholar
  22. 22.
    Eyre D. R., Muir H.: Type I and II collagens in intervertebral discs. Interchanging radial distributions in annulus fibro-sus. Biochem. J. 157: 267–270, 1970.Google Scholar
  23. 23.
    Fairbank J. C., Pynsent P. B., Van Poortvliet J. A. et al.: Influence of anthropometric factors and joint laxity in the incidence of adolescent back pain. Spine 9: 461–464, 1984.PubMedGoogle Scholar
  24. 24.
    Farfan H. F., Cossette J. W., Robertson G. H. et al.: The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J. Bone Joint Surg. 52-A: 468–497, 1970.Google Scholar
  25. 25.
    Farfan H. F., Sullivan J. D.: The relation of facet orientation to intervertebral disc failure. Can. J. Surg. 10: 179–185, 1967.PubMedGoogle Scholar
  26. 26.
    Fenstrom V.: Protruted lumbar intervertebral discs in children: Report of a case and review of the literature. Acta Chir. Scand. 111: 71–79, 1956.Google Scholar
  27. 27.
    Fisher V.: Vibrationsbedingte Wirbelsäulenschäden bei Hubschrauberpiloten. Arb. Med. Soz. Med. Prav. Med. 7: 161–163, 1980.Google Scholar
  28. 28.
    Friberg O.: Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine 8: 643–651, 1983.PubMedGoogle Scholar
  29. 29.
    Frymoyer J. W., Pope M. H., Clements J. H. et al.: Risk factors in low back pain. J. Bone Joint Surg. 65-A: 213–218, 1983.Google Scholar
  30. 30.
    Fujita K., Nakagawa T., Hirabayashi K. et al.: Neutral proteinases in human intervertebral disc. Role in degeneration and probable origin. Spine 18: 1766–1773, 1993.PubMedGoogle Scholar
  31. 31.
    Galante J. O.: Tensile properties of the human lumbar annulus fibrosus. Acta Orthop. Scand. Suppl. 100, 19671967.Google Scholar
  32. 32.
    Gertzbein D. S., Tile M., Gross A. et al.: Autoimmunity in degenerative disc disease of the lumbar spine. Orthop. Clin. North Am. 6: 67–73, 1983.Google Scholar
  33. 33.
    Gibson M. J., Szypryt E. P., Buckley J. H. et al.: Magnetic resonance imaging of adolescent disc herniation. J. Bone Joint Surg. 69-B: 699–703, 1987.Google Scholar
  34. 34.
    Giles L. G. F., Taylor J. R.: Low-back pain associated with leg length inequality. Spine 6: 510–521, 1981.PubMedGoogle Scholar
  35. 35.
    Gordon S. J., Yang K. H., Mayer P. J. et al.: Mechanism of disc rupture. A preliminary report. Spine 16: 450–456, 1991.PubMedGoogle Scholar
  36. 36.
    Gruber G. J., Ziperman H. H.: Relationship between whole-body vibration and morbidity patterns among motor coach operators. DHEW (NIOSH) Publication No 75–104, 1974.Google Scholar
  37. 37.
    Gunzburg R., Fraser R. D., Fraser G. A.: Lumbar intervertebral disc prolapse in teenage twins. A case report and review of the literature. J. Bone Joint Surg. 72-B: 914–916, 1990.Google Scholar
  38. 38.
    Gyntelberg F.: One year incidence of low back pain among male residents of Copenhagen aged 40–59. Danish Med. Bull. 21: 30–36, 1974.PubMedGoogle Scholar
  39. 39.
    Hagen R., Engesaeter L. B.: Unilateral and bilateral partial laminectomy in lumbar disc prolapse. A follow-up study of 156 patients. Acta Orthop. Scand. 48: 41–46, 1977.PubMedGoogle Scholar
  40. 40.
    Harada Y., Nakahara S.: A pathologic study of lumbar disc herniation in the elderly. Spine 14: 1020–1024, 1989.PubMedGoogle Scholar
  41. 41.
    Haut R. C.: Age-dependent influence of strain rate on the tensile failure of rat-tail tendon. J. Biomech. Eng. 105: 296–299, 1983.PubMedGoogle Scholar
  42. 42.
    Heckman J. D., Sassard R.: Musculoskeletal considerations in pregnancy. J. Bone Joint Surg. 76-A: 1720–1730, 1994.Google Scholar
  43. 43.
    Heliovaara M.: Body height, obesity, and risk of herniated lumbar intervertebral disc. Spine 12: 469–472, 1987.PubMedGoogle Scholar
  44. 44.
    Heliovaara M.: Occupation and risk of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J. Chron. Dis. 40: 259–264, 1987.PubMedGoogle Scholar
  45. 45.
    Heliovaara M.: Epidemiology of sciatica and herniated lumbar intervertebral disc. The Social Insurance Institution, Finland, ML: 76, Helsinki, 1988.Google Scholar
  46. 46.
    Heliovaara M., Knekt P., Aromaa A.: Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J. Chron. Dis. 40: 251–258, 1987.PubMedGoogle Scholar
  47. 47.
    Hirsh C., Jonsson B., Lewin T.: Low back symptoms in a Swedish female population. Clin. Orthop. 63: 171–176, 1969.Google Scholar
  48. 48.
    Hirsh C., Nachemson A.: The reliability of lumbar disc surgery. Clin. Orthop. 29: 189–195, 1963.Google Scholar
  49. 49.
    Holm S.: Pathophysiology of disc degeneration. Acta Orthop. Scand. Suppl. 251, 64: 13–15, 1993.PubMedGoogle Scholar
  50. 50.
    Holm S., Nachemson A.: Variations in the nutrition of the intevertebral disc induced by motion. Spine 8: 866–874, 1983.PubMedGoogle Scholar
  51. 51.
    Holm S., Nachemson A.: Nutrition of the intervertebral disc: acute effects of cigarette smoking. An experimental study. Int. J. Microcirc. Clin. Exp. 3: 406, 1984.Google Scholar
  52. 52.
    Hrubec Z., Nashold B. S.: Epidemiology of lumbar disc lesions in the military in world war II. Am. J. Epidemiol. 102: 366–376, 1975.Google Scholar
  53. 53.
    Hulshof C., Van Zanten B. V.: Whole body vibration and low back pain. A review of epidemiological studies. Int. Arch. Occup. Environ. Health 59: 205–220, 1987.PubMedGoogle Scholar
  54. 54.
    Ishihara H., Tsuji H., Hirano N. et al.: Effects of continuous quantitative vibrations on rheologic and biological behaviors of the intervertebral disc. Spine 17: S7–12, 1992.PubMedGoogle Scholar
  55. 55.
    Jacchia G. E., Bardelli M., Barile L. et al.: Casistica, risultati e cause di insuccessi di ernie discali operate. Giorn. Ital. Ortop. Traumat. 6 (Suppl. 2): 5–23, 1980.Google Scholar
  56. 56.
    Johnson E., Chetty C., Moore I. et al.: The distribution and arrangement of elastic fibres in the intervertebral disc of the adult human. J. Anat. 135: 301–309, 1982.PubMedGoogle Scholar
  57. 57.
    Jones I. L., Klamfeldt A., Sandstrom T.: The effect of continuous mechanical pressure upon the turnover of articular cartilage proteoglycans in vitro. Clin. Orthop. 165: 283–289, 1982.PubMedGoogle Scholar
  58. 58.
    Kaapa E., Holm S., Lammi M. J. et al.: Proteoglycan chemistry in experimentally injured porcine intervertebral disk. J. Spinal Disord. 7: 296–306, 1994.PubMedGoogle Scholar
  59. 59.
    Kamijo K., Tsujimara H., Obara H. et al.: Evaluation of seating comfort. Society of Automotive Engineers technical paper series 820761: 1–6, 1982.Google Scholar
  60. 60.
    Kastelik J. R.: Structure and mechanical deformation of tendon collagen. Dissertation, Case Western Reserve University, Cleveland, Ohio, 1979.Google Scholar
  61. 61.
    Kelsey J. L.: An epidemiological study of the relationship between occupations and acute herniated lumbar intervertebral discs. Int. J. Epidemiol. 4: 197–205, 1975.PubMedGoogle Scholar
  62. 62.
    Kelsey J. L.: An epidemiological study of acute herniated lumbar intervertebral discs. Rheumatol. Rehabil. 14: 144–159, 1975.PubMedGoogle Scholar
  63. 63.
    Kelsey J. L.: Epidemiology of muskuloskeletal disorders. Oxford University Press, Oxford, 145–167, 1982.Google Scholar
  64. 64.
    Kelsey J. L., Githens P. B., O’Conner T. et al.: Acute prolapsed lumbar intervertebral disc. An epidemiologic study with special reference to driving automobiles and cigarette smoking. Spine 9: 608–613, 1984.PubMedGoogle Scholar
  65. 65.
    Kelsey J. L., Hardy R.: Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc. Am. J. Epidemiol. 102: 63–73, 1975.PubMedGoogle Scholar
  66. 66.
    Kelsey J. L., Githens P. B., White A. A. et al.: An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc. J. Orthop. Res. 2: 61–66, 1984.PubMedGoogle Scholar
  67. 67.
    Key J. A., Ford L. T.: Experimental intervertebral disc lesions. J. Bone Joint Surg. 30-A: 621, 1948.Google Scholar
  68. 68.
    Kling T. F.: Herniated nucleus pulposus and slipped vertebral apophysis. In: The pediatric spine. Principles and practice. Weinstein S. Ed., Raven Press, New York, 1994.Google Scholar
  69. 69.
    Koota K.: Tuki-ja liikuntaelinten tautien hoitoon liittyva sairaalankaytto Suomessa. Vuosen 1969 ja 1974 tilastotietoi-hin perustuva tutkimus. Tempere: Acta Universitatis Tamperensis A106, 1979.Google Scholar
  70. 70.
    Kozak J. L., Moien M.: Detailed diagnoses and surgical procedures for patients discharged from short-stay hospital, United States, 1983. Vital Health Stat. 13, No 82, 1985.Google Scholar
  71. 71.
    Kurihara A., Kotaoka O.: Lumbar disc herniation in children and adolescents. A review of 70 operated cases and their minimum 5-year follow-up studies. Spine 5: 443–451, 1980.PubMedGoogle Scholar
  72. 72.
    Lawrence J. S.: Rheumatism in populations. Heinemann, London, 1977.Google Scholar
  73. 73.
    Lipson S. J., Muir H.: Proteoglycans in experimental intervertebral disc degeneration. Spine 6: 194–210, 1981.PubMedGoogle Scholar
  74. 74.
    Liu Y. K., Goel V. K., Dejong A. et al.: Torsional fatigue of the lumbar intervertebral joints. Spine 10: 894–900, 1985.PubMedGoogle Scholar
  75. 75.
    Loback D., Yong-Hing K., Cassidy D. et al.: The relationship between facet orientation and lumbar disc herniation. The role of torsion in intervertebral disc failure. Orthop. Trans. 9: 560, 1985.Google Scholar
  76. 76.
    Magora A.: Investigation of the relation between low back pain and occupation. 3. Physical requirements: sitting, standing and weight lifting. Indust. Med. Surg. 41: 5–9, 1972.Google Scholar
  77. 77.
    Mantle M. J., Greenwood R. M., Currey H. L.: Backache in pregnancy Rheumatol. Rehab. 16: 95–101, 1977.Google Scholar
  78. 78.
    Marin G. A.: Lumbar disk protrusion. Evaluation and study of 600 diskectomies with one to ten years follow-up. Int. Surg. 59: 154–155, 1974.PubMedGoogle Scholar
  79. 79.
    Matsui H., Terahata N., Tsuji H. et al.: Familiar predisposition and clustering for Juvenile lumbar disc herniation. Spine 17: 1323–1328, 1992.PubMedGoogle Scholar
  80. 80.
    Matsui H., Tsuji H., Terahata N.: Juvenile lumbar herniated nucleus pulposus in monozygotic twins. Spine 15: 1228–1230, 1990.PubMedGoogle Scholar
  81. 81.
    McNally D. S., Adams M. A., Goodship A. E.: Can intervertebral disc prolapse be predicted by disc mechanics? Spine 18: 1525–1530, 1993.PubMedGoogle Scholar
  82. 82.
    Miller J. A. A., Schmatz C., Schultz A. B.: Lumbar disc degeneration: correlation with age, sex, and spine level in 600 autopsy specimens. Spine 13: 173–178, 1988.PubMedGoogle Scholar
  83. 83.
    Morein G., Goldgefter L., Kobyliansky E. et al.: Changes in the mechanical properties of rat tail tendon during postnatal ontogenesis. Anat. Embryol. (Berl.) 154: 121–124, 1978.Google Scholar
  84. 84.
    Mundt D. J., Kelsey J. L., Golden A. N. et al.: An epidemiologic study of non-occupational lifting as a risk factor for herniated lumbar intervertebral disc. Spine 18: 595–602, 1993.PubMedGoogle Scholar
  85. 85.
    Nachmenson A., Eck C., Lindstrom I. L. et al.: Chronic low back disability can largely be prevented: A prospective randomized trial in industry. AAOS 56th Annual Meeting, Las Vegas, 1989.Google Scholar
  86. 86.
    Naylor A.: The late results of laminectomy for lumbar disc prolapse. A review after ten to twenty-five years. J. Bone Joint Surg. 56-B: 17–29, 1974.Google Scholar
  87. 87.
    Nelson C. L., Janecki C. L., Gildeberg P. L. et al.: Disc protrusion in the young. Clin. Orthop. 88: 142–150, 1972.PubMedGoogle Scholar
  88. 88.
    Nikiforov O.: Yleissairaalahoito Suomessa 1960-ja 1970-luvulla (English summary: General hospital care in Finland in the 1960s and 1970s). Helsinki: Laakintohallitusksen tutkimuksia 32, 1984.Google Scholar
  89. 89.
    O’Connell J. E. A.: Intervertebral disc protrusions in children and adolescents. Br. J. Surg. 47: 611–616, 1960.Google Scholar
  90. 90.
    O’Connell J. E. A.: Lumbar disc protrusion in pregnancy. J. Neurol. Neurosurg. Psychiat. 23: 138–141, 1960.Google Scholar
  91. 91.
    Ohshima H., Tsuji H., Hirano N. et al.: Water diffusion pathway, swelling pressure, and biomechanical properties of the intervertebral disc during compression load. Spine 14: 1234–1244, 1989.PubMedGoogle Scholar
  92. 92.
    Oppel F., Schramm J., Schirmer M. et al.: Results and complicated course after surgery for lumbar disc herniation. Adv. Neurosurg. 4: 36–51, 1977.Google Scholar
  93. 93.
    Ostgaard H. C., Andersson G. B.: Previous back pain and risk of developing back pain in future pregnancy. Spine 16: 432–436, 1991.PubMedGoogle Scholar
  94. 94.
    Osti O. L., Vernon-Roberts B., Fraser R. D.: Annulus tears and intervertebral disc degeneration. An experimental study using an animal model. Spine 15: 762–767, 1990.PubMedGoogle Scholar
  95. 95.
    Paine K. W. E., Haung P. W. H.: Lumbar disc syndrome. J. Neurosurg. 37: 75–82, 1972.PubMedGoogle Scholar
  96. 96.
    Pokras R., Graves E. J., Dennison C. F.: Surgical operations in short-stay hospitals: United States, 1978. Vital Health Stat. 13, No 61, 1982.Google Scholar
  97. 97.
    Pope M. H., Bevins T., Wilder D. et al.: The relationship between anthropometric, postural, muscular, and mobility characteristics of males ages 18–55. Spine 10: 644–648, 1985.PubMedGoogle Scholar
  98. 98.
    Pope M. H., Wilder D., Frymoyer J. W.: Vibration as an etiologic factors in low back pain. Institution of Mechanical Engineers Conference Publications: 11–17, 1980.Google Scholar
  99. 99.
    Porter R. W., Thorp L.: Familial aspects of disc protrusion. Orthop. Trans. 10: 524, 1986.Google Scholar
  100. 100.
    Postacchini F., Lami R., Pugliese O.: Familial predisposition to discogenic low-back pain. An epidemiologic and immunogenetic study. Spine 13: 1403–1406, 1988.PubMedGoogle Scholar
  101. 101.
    Pratt E. S., Green D. A., Spengler D. M.: Herniated intervertebral disc associated with unstable spinal injuries. Spine 15: 662–666, 1990.PubMedGoogle Scholar
  102. 102.
    Raaf J.: Some observations regarding 905 patients operated upon for protruded lumbar intervertebral disc. Am. J. Surg. 97: 388–399, 1959.PubMedGoogle Scholar
  103. 103.
    Rao V. K., Morrison W. A., McCobrien B.: Effect of nicotine on blood flow and patency of experimental microvascular anastomosis. Ann. Plast. Surg. 11: 206–209, 1983.PubMedGoogle Scholar
  104. 104.
    Rissanen P. M.: The surgical anatomy and pathology of the supraspinous and interspinous ligaments of the lumbar spine with special reference to ligament ruptures. Acta Orthop. Scand. Suppl.: 46, 1960.Google Scholar
  105. 105.
    Rowe M. L.: Disc surgery and chronic low back pain. J. Occup. Med. 7: 196–202, 1965.PubMedGoogle Scholar
  106. 106.
    Russwurm H., Bjerkreim I., Ronglan E.: Lumbar intervertebral disc herniation in the young. Acta Orthop. Scand. 49: 158–163, 1978.PubMedGoogle Scholar
  107. 107.
    Schneiderman R., Keret D., Maroudas A.: Effects of mechanical and osmotic pressure on the rate of glycosaminoglycan synthesis in the human adult femoral head cartilage: An in vitro study. J. Orthop. Res. 4: 393–408, 1986.PubMedGoogle Scholar
  108. 108.
    Shirazi A.: Strain in fibers of a lumbar disc. Analysis of the role of lifting in producing disc prolapse. Spine 14: 96–103, 1989.Google Scholar
  109. 109.
    Shirazi-Adl A.: Finite-element simulation of changes in the fluid content of human lumbar discs. Mechanical and clinical implications. Spine 17: 206–212, 1992.PubMedGoogle Scholar
  110. 110.
    Silverman N. A., Potvin C., Alexander J. C. et al.: In vitro lymphocyte reactivity and T-cell levels in chronic cigarette smokers. Clin. Exp. Immunol. 22: 285–292, 1975.PubMedGoogle Scholar
  111. 111.
    Smith J. W., Walmsley R.: Experimental incision of the intervertebral disc. J. Bone Joint Surg. 33-B: 612–625, 1951.Google Scholar
  112. 112.
    Soini J., Snellman O.: Lannerankaan Kohdistuneet ortope-diset leikkauset Suomessa vuonna 1980. Suomen Ortopedia ja Traumatologia 6: 29–30, 1983.Google Scholar
  113. 113.
    Soukka A., Alaranta H., Tallroth K. et al.: Leg-length inequality in people of working age. The association between mild inequality and low back pain is questionable. Spine 16: 429–431, 1991.PubMedGoogle Scholar
  114. 114.
    Spangfort E. V.: The lumbar disc herniation. Acta Orthop. Scand. Suppl. 142, 1972.Google Scholar
  115. 115.
    Stikeleather L. F., Hall G. O., Radke A. O.: A study of vehicle vibration spectra as related to seating dynamics. Soc. Automotive Eng. Trans.: 1–23, 1973.Google Scholar
  116. 116.
    Sward L., Hellstrom M., Jacobsson B. et al.: Disc degeneration and associated abnormalities of the spine in elite gymnast. A magnetic resonance imaging study. Spine 16: 437–443, 1991.PubMedGoogle Scholar
  117. 117.
    Szypryt E. P., Twining P., Wilde G. P. et al.: Diagnosis of lumbar disc protrusion: a comparison between magnetic resonance imaging and radiculography. J. Bone Joint Surg. 70-B: 717–722, 1988.Google Scholar
  118. 118.
    Terhaag D., Frowein R. A.: Traumatic disc prolapse. Neurosurg. Rev. 12, Suppl. 1: 588–592, 1989.PubMedGoogle Scholar
  119. 119.
    Thomas M., Grant N., Marshall J. et al.: Surgical treatment of low backache and sciatica. Lancet 2: 1437–1439, 1983.PubMedGoogle Scholar
  120. 120.
    Troup J. D. G.: Driver’s back pain and its prevention: a review of the postural, vibratory and muscular factors, together with the problem of transmitted road-shock. Appl. Ergon. 9: 207, 1978.PubMedGoogle Scholar
  121. 121.
    Uyttendaele D., Vandendriessche G., Vercauteren M. et al.: Sicklisting due to low back pain at the Ghent State University and University Hospital. Acta Orthop. Belg. 47: 523–546, 1981.PubMedGoogle Scholar
  122. 122.
    Varlotta G. P., Browm M. D., Kelsey J. L. et al.: Familial predisposition for herniation of a lumbar disc in patients who are less than twenty-one years old. J. Bone Joint Surg. 73-A: 124–128, 1991.Google Scholar
  123. 123.
    Vernon-Roberts B.: The pathology and interrelation of intervertebral disc lesions, osteoarthrosis of the apophyseal joints, lumbar spondylosis and low back pain. In: The lumbar spine and back pain. Jayson M. I. V. Ed., Pitman Medical Publishing, Kent, 83–114, 1980.Google Scholar
  124. 124.
    Videman T., Nurminen T., Tola S. et al.: Low back pain in nurses and some loading factors of work. Spine 9: 400–404, 1984.PubMedGoogle Scholar
  125. 125.
    Vogt K.-H.: Egebnisse nach lumbaler Bandscheibenoperation. Z. Orthop. 112: 821–822, 1974.PubMedGoogle Scholar
  126. 126.
    Webb J. H., Svien H. J., Kennedy R. L. J.: Protruted lumbar intervertebral discs in children. JAMA 154: 1153–1154, 1954.Google Scholar
  127. 127.
    Weinreb J. C., Wolbarsht L. B., Cohen J. M. et al.: Prevalence of lumbosacral intervertebral disc abnormalities on MR images in pregnant and asymptomatic nonpregnant women. Radiology 170: 125–128, 1989.PubMedGoogle Scholar
  128. 128.
    Weiss J. B., Quennel R., Jayson M. I. V.: Abnormal connective tissue degrading enzyme patterns in prolapsed intervertebral discs. Spine 11: 695–701, 1986.PubMedGoogle Scholar
  129. 129.
    Wickstrom G., Hanninen K., Lehtinen M. et al.: Previous back syndromes and present back symptoms in concrete reinforcement workers. Scand. J. Work. Environ. Health (Suppl. 4) 1: 20–29, 1978.Google Scholar
  130. 130.
    Wilder D. G., Woodworth B. B., Frymoyer J. W. et al.: Vibration and the human spine. Spine 7: 243, 1982.PubMedGoogle Scholar
  131. 131.
    Wood P. H., Badley E. M.: Musculoskeletal system. In: Oxford texbook of public health. Vol. 4. Specific applications, Holland W. W., Detels R., Knox G., Greeze E. Eds., Oxford University Press, Oxford, pp. 279–297, 1985.Google Scholar
  132. 132.
    Wood P. H. N., Badley E. M.: Epidemiology of back pain. In: The lumbar spine and back pain. Jayson M. I. V. Ed., Churchill Livingstone, London, pp. 1–15, 1987.Google Scholar
  133. 133.
    Yasuma T., Makino E., Saito S. et al.: Histological development of intervertebral disc herniation. J. Bone Joint Surg. 68-A: 1066–1072, 1986.Google Scholar
  134. 134.
    Zerbi E., Zagra A., Lamartina C. et al.: Casistica, risultati e cause di insuccessi in operati di ernia discale. Giorn. Ital. Ortop. Traumat. 6 (Suppl. 2): 25–34, 1980.Google Scholar

Copyright information

© Springer-Verlag Wien 1999

Authors and Affiliations

  • F. Postacchini
  • G. Cinotti

There are no affiliations available

Personalised recommendations