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Eur Spine J. 2019 Feb 11. doi: 10.1007/s00586-019-05905-6. [Epub ahead of print]

Pubertal development and growth are prospectively associated with spinal pain in young people (CHAMPS study-DK).

Author information

1
Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada. J.Hebert@unb.ca.
2
School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia. J.Hebert@unb.ca.
3
Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark.
4
Private Practice, Haderslev, Denmark.
5
Danish Agency for Patient Complaints, Aarhus, Denmark.
6
Institut Franco-Européen de Chiropraxie, Ivry sur Seine, France.
7
CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405, Orsay Cedex, France.
8
CIAMS, Université d'Orléans, 45067, Orléans, France.
9
Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
10
Canada East Spine Centre, Saint John, NB, Canada.
11
Department of Orthopaedic Surgery, Saint John Regional Hospital, Saint John, NB, Canada.
12
Department of Orthopaedic Surgery, Dalhousie University, Halifax, NS, Canada.
13
Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada.
14
Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark.
15
Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark.

Abstract

PURPOSE:

To examine the prospective associations of pubertal development and linear growth with spinal pain frequency and duration in children.

METHODS:

We recruited students from 10 public primary schools. Over 42 months, pubertal development was assessed four times and categorized according to Tanner stages 1-5, and height was measured on seven occasions. Occurrences of spinal pain were reported weekly via text messaging. We constructed variables for spinal pain duration (total weeks with pain) and frequency (number of episodes). Potential associations between pubertal development and growth were examined with generalized estimating equations and reported with incident rate ratios (IRRs). All models were adjusted for potential confounders.

RESULTS:

Data from 1021 children (53% female; mean [SD] age = 9.4 [1.4] years), with median participation duration of 39 months, were included. Advancing pubertal development was associated with increased spinal pain duration (IRR [95% CI] = 1.90 [1.45, 2.49] to 5.78 [4.03, 8.29]) and frequency of pain episodes (IRR [95% CI] = 1.32 [1.07, 1.65] to 2.99 [2.24, 3.98]). Similar associations were observed for each 1-cm change in height in 6 months with spinal pain duration (IRR [95% CI] = 1.19 [1.15, 1.23]) and frequency (IRR [95% CI] = 1.14 [1.11, 1.17]). The relations between pubertal development and spinal pain, as well as growth and spinal pain, were largely independent.

CONCLUSIONS:

In young people, pubertal development and linear growth are likely to be independent risk factors for the development of spinal pain. Pubertal development demonstrates evidence of dose-response in its relationship with spinal pain. This knowledge may assist healthcare providers with clinical decision-making when caring for pediatric patients. These slides can be retrieved under Electronic Supplementary Material.

KEYWORDS:

Back pain; Body height; Growth and development; Puberty; Risk factors

PMID:
30740638
DOI:
10.1007/s00586-019-05905-6

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