title: Generalized Joint Laxity is Associated with Primary Occurrence and Treatment Outcome of Lumbar Disc Herniation.
abstract: BACKGROUND
  We investigated relationships between generalized joint laxity and primary lumbar disc herniation occurrence and compared clinical outcomes after conservative treatment in lumbar disc herniation patients with and without generalized joint laxity.
  
  
  METHODS
  The study group included 128 men, and the control group included 276 men matched for age and body mass index with the study group. The primary outcome measure was the presence or absence of generalized joint laxity using the Beighton scale. Clinical outcomes measured by the visual analog scale and the Oswestry disability index 2 years after conservative treatment were the secondary outcome measure.
  
  
  RESULTS
  Generalized joint laxity prevalence was 13.2% in the study group and 5.1% in the control group, a significant difference (P=0.01). Spearman correlation analysis revealed that weight (r=0.162, P=0.03), body mass index (r=0.131, P=0.03), and generalized joint laxity (r=0.372, P<0.01) significantly correlated with lumbar disc herniation occurrence. In multivariate regression analysis, generalized joint laxity was the only significant lumbar disc herniation predictor (P=0.002; 95% confidence interval, 1.08 to 5.26). Generalized joint laxity in lumbar disc herniation patients was associated with worse clinical outcomes after conservative treatment measured by visual analog scale scores for lower extremity pain (P=0.02), lower back pain (P=0.03), and Oswestry disability index scores (P=0.03).
  
  
  CONCLUSIONS
  Generalized joint laxity might be associated with lumbar disc herniation occurrence and might also be a negative predictor of worse clinical outcomes after conservative treatment.
authors.affiliation: Department of Family Medicine, Myongji Hospital, Goyang, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Han
authors.affiliation: Department of Family Medicine, Myongji Hospital, Goyang, Korea.
authors.forename: Hong-Bae
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju, Korea.
authors.forename: Gun Woo
authors.initials: GW
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Myongji Hospital, Goyang, Korea.
authors.forename: Jung Heum
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Family Medicine, Myongji Hospital, Goyang, Korea.
authors.forename: Won Jin
authors.initials: WJ
authors.lastname: Jo
authors.affiliation: Department of Family Medicine, Myongji Hospital, Goyang, Korea.
authors.forename: Sun-Mi
authors.initials: SM
authors.lastname: Lee
keywords: Intervertebral Disc Displacement; Joint Instability; Lumbar Vertebrae