The Occurrence of Anular Tears and Their Relation to Lifetime Back Pain History: A Cadaveric Study Using Barium Sulfate Discography
Notice bibliographique
Résumé
In Brief Study Design. The occurrence of anular tears and general disc degeneration of the lumbar spine was studied in relation to the lifetime frequency of back pain. Summary of Background Data. Although anular tears and ruptures are common targets for diagnostic and therapeutic approaches, the relationship between disc findings and back pain has been weak or nonexistent. Methods. The data comprised barium sulfate discograms of lumbar spine levels from 157 male cadavers. The extent of “anular tears” and “general disc degeneration” based on posterior-anterior and side views were evaluated separately using a 4-point scale. Lifetime history of back pain occurrence and work were obtained from the families of 86 cadavers. To assess whether the risk of back pain changed with the severity of findings or the level of disc, we applied trend tests and proportional-odds logistic models for occurrence data. Results. In early adulthood, the risk of anular tears was 0.6 to 0.7, whereas at retirement age, tears were practically unavoidable. The risk of full anular tears with barium sulfate leaking (“leaking” tear) was estimated to be 0.10 and 0.35 among the men in the age groups of 20 to 49 and 50 to 59 years, respectively. The risk of “leaking” tears was greatest at the L5–S1 levels. There were less severe degenerative findings associated with sedentary occupation but no differences between driving and physically light and heavy occupations. Overall, the risk of any anular tears and any general degeneration as defined was similar. The frequency of back pain had a highly significant relation to the occurrence of tears (model-based P = 0.0009). With a “leaking” tear, the model-based estimate of the risk of frequent lifetime back pain was 0.42, with an “outer” tear the risk was 0.20, and with no tears or “inner” tears the risk was 0.10 (the observed prevalence was 0). The effect of occupational loading was of borderline significance (P = 0.045). Conclusion. Anular degeneration of the lumbar discs appear earlier and are more clearly related to back pain than previously thought, most probably due to the better sensitivity of the BaSO4 discography method to detect tears. The occurrence of anular tears general and disc degeneration was studied in relation to the lifetime frequency of back pain using BaSO4 discograms of lumbar spine from cadavers. Lifetime history of back pain occurrence and work were obtained from the families. Anular degeneration of the lumbar discs appears earlier and is more clearly related to back pain than previously thought. Heavy physical loading seems to exacerbate back pain but has only a minor effect on disc degeneration.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».