[Occupational disease 2108. Degenerative changes of the cervical spine as a causality criterion in the assessment of discogenic diseases according to BeKV 2108].
With the second amendment to the Ordinance on Occupational Diseases (BeKV) of 18 December 1992, discogenic diseases of the spine are included in the disease register of occupational diseases for the first time. If occupations that impose stress on the spine have been practised for many years, the possibility exists of recognizing degenerative diseases as an occupational disease. In assessment practice, the radiological data on the spine exposed to stress is compared with that of regions which are remote from the stress (cervical/thoracic spine). This pattern of the distribution of degenerative disease is then used as the basis for determining a causal relationship between the occupation causing the stress and disease of the axial skeleton. The pattern of degeneration of the cervical spine was investigated in two groups, one with ( n =153) and one without ( n =333) occupations that impose stress on the lumbar spine. A cumulative score of degenerative changes was elaborated and presented as a new classification. No differences were found between the groups with regard to either the frequency of occurrence, segmental distribution or severity of disease. In both groups, degenerative changes correlated with age. The prevailing assessment practice is discussed on the basis of these data.
Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie der Universität Ulm. erich.hartwig@medizin.uni-ulm.de
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E
Hartwig
M
M
Schultheiss
S
S
Krämer
V
V
Ebert
L
L
Kinzl
M
M
Kramer
D000328:Adult; D015984:Causality; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005260:Female; D005858:Germany; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011859:Radiography; D013122:Spinal Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology; D013128:Spinal Osteophytosis / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology; D013312:Stress, Physiological / Q000150:complications; D016474:Weight-Bearing; D014911:Whiplash Injuries / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology