{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:04:40Z","timestamp":1788242680567,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81874022"],"award-info":[{"award-number":["81874022"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82102522"],"award-info":[{"award-number":["82102522"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172483"],"award-info":[{"award-number":["82172483"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014103","name":"Key Technology Research and Development Program of Shandong Province","doi-asserted-by":"publisher","award":["2022CXGC010503"],"award-info":[{"award-number":["2022CXGC010503"]}],"id":[{"id":"10.13039\/100014103","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR202102210113"],"award-info":[{"award-number":["ZR202102210113"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Given the distinct physiological and societal traits between women and men, we propose that there are distinct risk factors for lumbar degenerative disc disease surgeries, including lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS), in middle\u2010aged and older populations. However, few studies have focused on middle\u2010aged and older women. This study aims to identify these risk factors specifically in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this case\u2013control study, the study group comprised 1202 women aged \u2265\u200945\u2009years who underwent operative treatment of lumbar degenerative disc disease (LDH, <jats:italic>n<\/jats:italic>\u2009=\u2009825; LSS, <jats:italic>n<\/jats:italic>\u2009=\u2009377), and the control group comprised 1168 women without lumbar disease who visited a health examination clinic during the same period. The study factors included demographics (age, body mass index [BMI], smoking, labor intensity, and genetic history), female\u2010specific factors (menopausal status, number of deliveries, cesarean section, and simple hysterectomy), surgical history (number of abdominal surgeries, hip joint surgery, knee joint surgery, and thyroidectomy), and systemic diseases (hypercholesterolemia, hypertriglyceridemia, hyper\u2010low\u2010density lipoprotein cholesterolemia, hypertension, diabetes, cardiovascular disease, and cerebrovascular disease). Multivariate binary logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The risk factors for surgical treatment of LDH in middle\u2010aged and older women included BMI (OR\u2009=\u20091.603), labor intensity (OR\u2009=\u20091.189), genetic history (OR\u2009=\u20092.212), number of deliveries (OR\u2009=\u20091.736), simple hysterectomy (OR\u2009=\u20092.511), hypertriglyceridemia (OR\u2009=\u20091.932), and hyper\u2010low\u2010density lipoprotein cholesterolemia (OR\u2009=\u20092.662). For surgical treatment of LSS, the risk factors were age (OR\u2009=\u20091.889), BMI (OR\u2009=\u20091.671), genetic history (OR\u2009=\u20092.134), number of deliveries (OR\u2009=\u20092.962), simple hysterectomy (OR\u2009=\u20091.968), knee joint surgery (OR\u2009=\u20092.527), hypertriglyceridemia (OR\u2009=\u20091.476), hyper\u2010low\u2010density lipoprotein cholesterolemia (OR\u2009=\u20092.413), and diabetes (OR\u2009=\u20091.643). Cerebrovascular disease was a protective factor against surgery for LDH (OR\u2009=\u20090.267).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BMI, genetic history, number of deliveries, simple hysterectomy, hypertriglyceridemia, and hyper\u2010low\u2010density lipoprotein cholesterolemia were independent risk factors for surgical treatment of both LDH and LSS in middle\u2010aged and older women. Two disparities were found: labor intensity was a risk factor for LDH patients, and knee joint surgery and diabetes were risk factors for LSS patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14066","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T02:53:11Z","timestamp":1713495191000},"page":"1284-1291","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk Factors for Surgical Treatment of Lumbar Degenerative Disc Disease in Middle\u2010aged and Older Women: A Prospective Case\u2013Control Study of 2370 Subjects"],"prefix":"10.1111","volume":"16","author":[{"given":"Yuchen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suomao","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit, Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaorong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Zhangqiu District People's Hospital  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghao","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianlei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4347-1633","authenticated-orcid":false,"given":"Xinyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181a3c2de"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22957"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3164"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/oem.60.11.821"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030409"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0092-8674(01)00268-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-01427-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2007.05.011"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei251"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-238"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2015.09.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.77B1.7822369"},{"issue":"5","key":"e_1_2_11_14_1","first-page":"361","article-title":"Pregnancy and the syndrome of herniated lumbar intervertebral disc; 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