AB088. SOH24AB_172. Lumbar disc herniations in females: comparative risk factors for pre-menopausal versus post-menopausal cohorts and emerging etiopathogenesis of disc disease in younger patients
Orthopaedic Session I

AB088. SOH24AB_172. Lumbar disc herniations in females: comparative risk factors for pre-menopausal versus post-menopausal cohorts and emerging etiopathogenesis of disc disease in younger patients

Kielan Wilson1, Jake McDonnell2, Luke Turley3, Trinh Ton Nu Ngoc4, Gráinne Cunniffe2, Stacey Darwish2, Conor Buckley5, Joseph Simon Butler2

1School of Medicine, University College Dublin, Belfield, Dublin, Ireland; 2National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; 3Department of Orthopaedics, Tallaght University Hospital, Dublin, Ireland; 4School of Medicine, National University of Galway, Galway, Ireland; 5Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland

Background: Lumbar disc disease can prove a debilitating injury. Typically, it is believed to be a multifactorial process inclusive of aging, obesity and abnormal biomechanical loading patterns in the spine. Nevertheless, traditional theories of pathophysiology may not hold true for younger populations. That serves the premise for this study, to investigate comparative risk factors for lumbar disc herniation (LDH) in pre- and post-menopausal female cohorts.

Methods: A retrospective review was conducted at our institution, a national tertiary referral centre, for female patients who underwent surgery for symptomatic LDH between June 2016 and May 2020. Patients were separated into two specific cohorts; those aged <45 years of age at the time of injury, termed the pre-menopausal cohort and those aged ≥45 years of age at the time of injury, termed the post-menopausal cohort. Demographic, clinical and radiological characteristics were collected and compared between groups.

Results: A total of 110 patients were identified (43 pre-menopausal, 67 post-menopausal). On univariate analysis, the pre-menopausal cohort had a significantly higher body mass index (BMI) (29.6 vs. 27.1 kg/m2; P=0.02), history of LDH (P=0.02), history of lumbar spine surgery (P=0.02), greater degree of psoas fat infiltration (P<0.001), lumbar lordosis (P<0.01) and proportion of distal lumbar lordosis (P=0.01). On multivariate analysis, only psoas fat infiltration retained its significance [odds ratio (OR): 1.78, 95% confidence interval (CI): 1.22:2.97, P<0.01].

Conclusions: Our findings show that pre-menopausal patients who presented with LDH were at risk of LDH due to a significantly greater degree of psoas fat infiltration when compared to the post-menopausal group.

Keywords: Disc herniation; female; lumbar; risk-factors; spine surgery

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab088
Cite this abstract as: Wilson K, McDonnell J, Turley L, Ngoc TTN, Cunniffe G, Darwish S, Buckley C, Butler JS. AB088. SOH24AB_172. Lumbar disc herniations in females: comparative risk factors for pre-menopausal versus post-menopausal cohorts and emerging etiopathogenesis of disc disease in younger patients. Mesentery Peritoneum 2024;8:AB088.

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