Relationship between individual payload weight and spondylolysis incidence in Turkish land forces

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>The aim of this study was to investigate the relationship between lumbar spondylolysis and payload weight between different combat units of Turkish land forces (TLF).</jats:p></jats:sec><jats:sec><jats:title>METHOD</jats:title><jats:p>The authors reviewed clinical and radiological data of the military personnel with low-back pain (LBP) admitted to their clinic between July 2017 and July 2018. Age, BMI, average payload weight, and military service unit were recorded. CT scans were evaluated for pars interarticularis fractures and spondylolisthesis, whereas MRI studies were evaluated for spondylolisthesis, Modic-type endplate changes, or signal loss on T2-weighted images compatible with disc degeneration.</jats:p></jats:sec><jats:sec><jats:title>RESULT</jats:title><jats:p>Following exclusion, a total of 642 all-male military personnel were included. Of these personnel, 122 were commandos, 435 were infantry, and 85 were serving in the artillery units. Bilateral pars interarticularis fracture was noted in 42 commandos (34.42%) and 2 infantrymen (0.45%). There was no spondylolysis in the artillery units. There was no multiple-level spondylolysis and the most common level of spondylolysis was L5. Commandos had a significantly higher incidence of spondylolysis and more average payload weight (p &lt; 0.001). Twelve patients (27.2%) with spondylolysis had accompanying MRI pathologies at the same level, whereas 32 patients (72.7%) had no accompanying MRI pathologies.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Increased payload weight in military personnel is associated with spondylolysis, and commandos in the TLF have significantly heavier payloads, which causes an increased rate of spondylolysis compared to other units. Additionally, spondylolysis without adjacent-level changes on MRI could be undiagnosed. LBP in active military personnel who have a history of carrying heavy payloads should be evaluated extensively with both MRI and CT scans.</jats:p></jats:sec>

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

“…none supported a negative correlation. Outcomes were consistent throughout the clinical studies that showed a positive correlation, with all studies using MRI to diagnose bony stress and IVD degeneration (6,7,(18)(19)(20)(21) (7), which may suggest the importance of diagnosing early signs of bony stress even if the healing occurs in subsequent follow-up scans. Bony stress may also be a contributing factor to the non-speci c LBP, due to its association with IVD degeneration or due to the microtrabecular injury alone or both.…”

Aberrant spinal mechanical loading stress triggers intervertebral disc degeneration by inducing pyroptosis and nerve ingrowth

“…Multiple clinical investigations have showed that congenital malformations of spine (including scoliosis, kyphosis, spina bifida, spondylolysis and Klippel Feil syndrome) 35,36 , accidental back injury or ligament injury [37][38][39] , occupational exposure (such as crane and car drivers, weightlifters, etc.) [40][41][42] could induce aberrant mechanical loading of lumbar spine, and finally lead to IVDD. Moreover, decompensated changes in lumbar spine structure result from abnormal mechanical environment, such as proliferation of facet joints 43 , formation of osteophytes 44 , hypertrophy of ligamentum flavum 45 or calcification of longitudinal ligament 46,47 , will fail to resist aberrant mechanical loading and eventually accelerate the process of IVDD in patients.…”

Moderate mechanical stimulation rescues degenerative annulus fibrosus by suppressing caveolin-1 mediated pro-inflammatory signaling pathway

“…Therefore, IVD is considered to be situated in a loaded environment, in which the cells are subjected to mechanical stimuli, involving in tensile, compressive and shear stresses 18 . Recent studies suggested the possibility of aberrant mechanical loading stresses in the aetiology of disc degeneration 46 , 47 . It is reported that excessive mechanical loading may result in deleterious changes of the discs by decreasing the expression level of anabolic genes, while simultaneously accelerating the expression of catabolic genes, such as Mmps and Adamts 48 .…”