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  • Role of Cardiovascular Risk Factors in Symptomatic Lumbar Disk Herniation: Myth or Reality?

    Final Number:

    Nese Keser MD; Erhan Çelikoglu; Merih Is; Zeynep Demet Ilgezdi; Bendigar Sunar; Yusuf Sinan Aydin; Ahmet Ugur Kevenk; Bora Gürer; Ali Fatih Ramazanoglu; Imam Hüseyin Aydin; Ibrahim Tutkan; Nurgül Keser

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: The intervertebral disk is the largest avascular tissue in the body and the nutrient supply is via diffusion through the vertebral endplate. Whether or not cardiovascular risk factors used as a surrogate for atherosclerosis might diminish this nutrient supply and lead to herniation as a consequence of ischemia has been an interesting research area.

    Methods: Group I(G-I) included 50 patients (mean age 41; 25 women, 25 men) with symptomatic lumbar disk herniation and Group II(G-II) included 50 patients (mean age 41, 25 women, 25 men) with nonspecific headache. Total cholesterol (TC), triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), fasting blood sugar (FBS), HbA1C levels were obtained. The TC /HDL-C ratio was calculated. History was taken to determine smoking, alcohol or drug consumption. The waist circumference and body mass index of all patients were measured. The IBM SPSS Statistics 22 (IBM SPSS, Turkey) program was used for statistical analysis. Significance was considered as p < 0.05.

    Results: There was no statistically significant difference between the two groups regarding the parameters measured (Table 1) (p>0.05). However, when we analyzed each group according to gender there was an interesting result. In the men in Group I, the TG levels (p: 0.001), TC/HDL-C ratio (p: 0.001), and systolic (SBP) (p: 0.006) and diastolic blood pressure (DBP) (p: 0.018) were higher and the HDL-C levels (p: 0.001) were lower compared to the men in Group II (Table 3). However this difference did not exist between the women in both groups (Table 2).

    Conclusions: Classically known atherosclerotic risk factors differ between men and women and between women according to menopausal status due to the protective effects of estrogen. Thus, for atherosclerosis, the impact of atherosclerotic risk factors on disk hernias should be evaluated for each patient individually, based on age and in the context of gender differences.

    Patient Care: The possibility of lumbar disc disease may be reduced if men protect themselves from atherosclerotic risk factors. However other factors (besides cardiovascular risk factors) should be sought in the etiology of lumbar disc disease in women before menaupose.

    Learning Objectives: The effect of atherosclerotic risk factors in the etiology of lumbar disc herniation before the age of 60 was investigated.


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