The relationship between intervertebral disc pathologies and the use of digital devices and lack of physical activity in adolescents

Disc pathologies, digital devices, and physical activity

Authors

Keywords:

Adolescents, disc pathologies, digital devices, physical activity

Abstract

Background/Aim: Existing research on herniated discs in adolescents primarily focuses on surgical interventions and outcomes, with fewer studies investigating the effectiveness of non-surgical therapies. The correlation between obesity, facet tropism, lumbosacral transitional vertebrae, trauma, certain sports activities, and herniated discs in adolescents is well-documented. Comparable to adults, a sedentary lifestyle in adolescents potentially carries a significant risk of developing disc degeneration and herniation. Consequently, this study aims to examine the relationship between increased digital device usage, decreased physical activity, and the onset of disc pathologies in adolescents.

Methods: The study group included 94 patients aged between 10 and 16 years diagnosed with cervical (CDH), thoracic (TDH), and lumbar (LDH) disc disease. For each participant, the individual daily usage time spent on desktop computers, tablets, laptops, and mobile phones and the total time spent on all digital devices were evaluated. Their level of physical activity was also assessed using the International Physical Activity Questionnaire – Short Form (IPAQ-SF). The study eliminated causes such as listhesis, facet tropism, lumbosacral transitional vertebra, trauma, and sports injuries that could prompt the development of these spinal pathologies. Additionally, other conditions that might cause spinal pain, such as scoliosis, rheumatological diseases with spinal involvement, tumors, and myofascial pain, were also ruled out.

Results: The average age of all patients was 13.44 (2.07) years. A majority were women (n=55), comprising 58.50% of the sample. Of the patients, 60.64% had CDH, 12.77% had TDH, and 75.53% had LDH. The amount of physical activity and time spent on digital devices were similar across both genders (P=0.194 and P=0.770). A significant correlation was found between CDH and the time spent on tablets, laptops, and mobile phones (P<0.001). Again, a significant correlation was observed between LDH, usage of desktop computers, total time spent on all digital devices, and the IPAQ-SF score for low physical activity (P<0.001).

Conclusion: The prevalence and duration of digital device use among adolescents are increasing, while physical activity is decreasing. Our study indicates that this situation may be linked to the development of disc degeneration and hernias. Understanding this association can help reduce treatment and rehabilitation costs and prevent the potential loss of workability and quality of life resulting from a herniated disc. Consequently, additional comparative research on this topic is crucial.

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References

Silva GR, Pitangui AC, Xavier MK, Correia-Júnior MA, De Araújo RC. Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use. J Pediatr (Rio J). 2016 Mar-Apr;92(2):188-96. DOI: https://doi.org/10.1016/j.jped.2015.06.006

Casser HR, Schaible HG. Muskuloskeletaler Schmerz [Musculoskeletal pain]. Schmerz. 2015 Oct;29(5):486-8, 490-5. German. DOI: https://doi.org/10.1007/s00482-015-0046-9

Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine (Phila Pa 1976). 1996 Oct 15;21(20):2323-8. DOI: https://doi.org/10.1097/00007632-199610150-00004

Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29,424 individuals aged 12-41 years. Spine (Phila Pa 1976). 1998 Jan 15;23(2):228-34. DOI: https://doi.org/10.1097/00007632-199801150-00015

Cakmak A, Yücel B, Ozyalcin SN, Bayraktar B, Ural HI, Duruöz MT, et al. The frequency and associated factors of low back pain among a younger population in Turkey. Spine (Phila Pa 1976). 2004 Jul 15;29(14):1567-72. DOI: https://doi.org/10.1097/01.BRS.0000131432.72531.96

Turk Z, Vauhnik R, Micetić-Turk D. Prevalence of nonspecific low back pain in schoolchildren in north-eastern Slovenia. Coll Antropol. 2011 Dec;35(4):1031-5. PMID: 22397234.

Yao W, Mai X, Luo C, Ai F, Chen Q. A cross-sectional survey of nonspecific low back pain among 2083 schoolchildren in China. Spine (Phila Pa 1976). 2011 Oct 15;36(22):1885-90. DOI: https://doi.org/10.1097/BRS.0b013e3181faadea

Calvo-Muñoz I, Gómez-Conesa A, Sánchez-Meca J. Prevalence of low back pain in children and adolescents: a meta-analysis. BMC Pediatr. 2013 Jan 26;13:14. DOI: https://doi.org/10.1186/1471-2431-13-14

Li Y, Shi JJ, Ren J, Guan HS, Gao YP, Zhao F, et al. [Relationship between obesity and lumbar disc herniation in adolescents]. Zhongguo Gu Shang. 2020 Aug 25;33(8):725-9. Chinese.

Wang H, Zhou Y. Facet tropism: possible role in the pathology of lumbar disc herniation in adolescents. J Neurosurg Pediatr. 2016 Jul;18(1):111-5. DOI: https://doi.org/10.3171/2015.7.PEDS15175

Zhang B, Wang L, Wang H, Guo Q, Lu X, Chen D. Lumbosacral Transitional Vertebra: Possible Role in the Pathogenesis of Adolescent Lumbar Disc Herniation. World Neurosurg. 2017 Nov;107:983-989. DOI: https://doi.org/10.1016/j.wneu.2017.07.095

Villarejo-Ortega FJ, Torres Campa-Santamarina JM, Bencosme-Abinader JA, Alvarez- Sastre C, Pascual Martín-Gamero A, Pérez-Díaz C, et al. Hernia discal lumbar en adolescentes [Lumbar disc disease in adolescents]. Rev Neurol. 2003 Mar 16-31;36(6):514-7. Spanish. PMID: 12652411. DOI: https://doi.org/10.33588/rn.3606.2002025

Hakala PT, Rimpelä AH, Saarni LA, Salminen JJ. Frequent computer-related activities increase the risk of neck-shoulder and lower back pain in adolescents. Eur J Public Health. 2006 Oct;16(5):536-41. DOI: https://doi.org/10.1093/eurpub/ckl025

Diepenmaat AC, van der Wal MF, de Vet HC, Hirasing RA. Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics. 2006 Feb;117(2):412-6. DOI: https://doi.org/10.1542/peds.2004-2766

Karademir M, Eser O, Karavelioglu E. Adolescent lumbar disc herniation: Impact, diagnosis, and treatment. J Back Musculoskelet Rehabil. 2017;30(2):347-52. DOI: https://doi.org/10.3233/BMR-160572

Choy WJ, Phan K, Diwan AD, Ong CS, Mobbs RJ. Annular closure device for disc herniation: meta-analysis of clinical outcome and complications. BMC Musculoskelet Disord. 2018 Aug 16;19(1):290. DOI: https://doi.org/10.1186/s12891-018-2213-5

Raghu ALB, Wiggins A, Kandasamy J. Surgical management of lumbar disc herniation in children and adolescents. Clin Neurol Neurosurg. 2019 Oct;185:105486. DOI: https://doi.org/10.1016/j.clineuro.2019.105486

Chen Y, Song R, Huang W, Chang Z. Percutaneous endoscopic discectomy in adolescent lumbar disc herniation: a 3- to 5-year study. J Neurosurg Pediatr. 2018 Nov 2;23(2):251-8. DOI: https://doi.org/10.3171/2018.8.PEDS18442

Lee DY, Ahn Y, Lee SH. Percutaneous endoscopic lumbar discectomy for adolescent lumbar disc herniation: surgical outcomes in 46 consecutive patients. Mt Sinai J Med. 2006 Oct;73(6):864-70. PMID: 17117312.

Wang Y, Xu Y, Tian G, Dai G. Paediatric lumbar disc herniation: a report of two cases and review of the literature. Eur J Med Res. 2022 Jun 3;27(1):82. DOI: https://doi.org/10.1186/s40001-022-00696-x

Zhuang L, Wang L, Xu D, Wang Z, Liang R. Association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain. J Orthop Sci. 2021 Jan;26(1):110-5. DOI: https://doi.org/10.1016/j.jos.2020.02.009

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381-95. DOI: https://doi.org/10.1249/01.MSS.0000078924.61453.FB

Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010 Aug;111(1):278-84. DOI: https://doi.org/10.2466/06.08.PMS.111.4.278-284

Humzah MD, Soames RW. Human intervertebral disc: structure and function. Anat Rec. 1988 Apr;220(4):337-56. DOI: https://doi.org/10.1002/ar.1092200402

Schroeder GD, Guyre CA, Vaccaro AR. The epidemiology and pathophysiology of lumbar disc herniations. Seminars Spine Surg. 2016;28:2–7. DOI: https://doi.org/10.1053/j.semss.2015.08.003

Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006 Jun 17;332(7555):1430-4. DOI: https://doi.org/10.1136/bmj.332.7555.1430

Raj PP. Intervertebral disc: anatomy-physiology-pathophysiology-treatment. Pain Pract. 2008 Jan-Feb;8(1):18-44. DOI: https://doi.org/10.1111/j.1533-2500.2007.00171.x

Roberts S, Evans H, Trivedi J, Menage J. Histology and pathology of the human intervertebral disc. J Bone Joint Surg Am. 2006 Apr;88 Suppl 2:10-4. DOI: https://doi.org/10.2106/JBJS.F.00019

Lee JY, Ernestus RI, Schröder R, Klug N. Histological study of lumbar intervertebral disc herniation in adolescents. Acta Neurochir (Wien). 2000;142(10):1107-10. DOI: https://doi.org/10.1007/s007010070037

Ekşi MŞ, Özcan-Ekşi EE, Özmen BB, Turgut VU, Huet SE, Dinç T, et al. Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain. J Pediatr Orthop B. 2022 Jan 1;31(1):93-102. DOI: https://doi.org/10.1097/BPB.0000000000000833

Kumar R, Kumar V, Das NK, Behari S, Mahapatra AK. Adolescent lumbar disc disease: findings and outcome. Childs Nerv Syst. 2007 Nov;23(11):1295-9. DOI: https://doi.org/10.1007/s00381-007-0370-1

Zamani MH, MacEwen GD. Herniation of the lumbar disc in children and adolescents. J Pediatr Orthop. 1982;2(5):528-33. DOI: https://doi.org/10.1097/01241398-198212000-00012

Clarke NM, Cleak DK. Intervertebral lumbar disc prolapse in children and adolescents. J Pediatr Orthop. 1983 May;3(2):202-6. DOI: https://doi.org/10.1097/01241398-198305000-00009

DeLuca PF, Mason DE, Weiand R, Howard R, Bassett GS. Excision of herniated nucleus pulposus in children and adolescents. J Pediatr Orthop. 1994 May-Jun;14(3):318-22. DOI: https://doi.org/10.1097/01241398-199405000-00008

Yang IK, Bahk YW, Choi KH, Paik MW, Shinn KS. Posterior lumbar apophyseal ring fractures: a report of 20 cases. Neuroradiology. 1994 Aug;36(6):453-5. DOI: https://doi.org/10.1007/BF00593682

Banerian KG, Wang AM, Samberg LC, Kerr HH, Wesolowski DP. Association of vertebral end plate fracture with pediatric lumbar intervertebral disk herniation: value of CT and MR imaging. Radiology. 1990 Dec;177(3):763-5. DOI: https://doi.org/10.1148/radiology.177.3.2243985

Singhal A, Mitra A, Cochrane D, Steinbok P. Ring apophysis fracture in pediatric lumbar disc herniation: a common entity. Pediatr Neurosurg. 2013;49(1):16-20. DOI: https://doi.org/10.1159/000355127

Bento TPF, Cornelio GP, Perrucini PO, Simeão SFAP, de Conti MHS, de Vitta A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr (Rio J). 2020 Nov-Dec;96(6):717-24. DOI: https://doi.org/10.1016/j.jped.2019.07.008

Auvinen J, Tammelin T, Taimela S, Zitting P, Karppinen J. Associations of physical activity and inactivity with low back pain in adolescents. Scand J Med Sci Sports. 2008 Apr;18(2):188-94. DOI: https://doi.org/10.1111/j.1600-0838.2007.00672.x

Shan Z, Deng G, Li J, Li Y, Zhang Y, Zhao Q. Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai. PLoS One. 2013 Oct 11;8(10):e78109. DOI: https://doi.org/10.1371/journal.pone.0078109

Cho CY. Survey of faulty postures and associated factors among Chinese adolescents. J Manipulative Physiol Ther. 2008 Mar;31(3):224-9. DOI: https://doi.org/10.1016/j.jmpt.2008.02.003

Cagnie B, Danneels L, Van Tiggelen D, De Loose V, Cambier D. Individual and work related risk factors for neck pain among office workers: a cross sectional study. Eur Spine J. 2007 May;16(5):679-86. DOI: https://doi.org/10.1007/s00586-006-0269-7

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2024-07-22

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1.
Ozmaden Hantal A, Iptec M. The relationship between intervertebral disc pathologies and the use of digital devices and lack of physical activity in adolescents: Disc pathologies, digital devices, and physical activity. J Surg Med [Internet]. 2024 Jul. 22 [cited 2024 Dec. 22];8(7):117-22. Available from: https://jsurgmed.com/article/view/8082