{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:25Z","timestamp":1787755825160,"version":"build-2784847793"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is growing evidence to suggest a potential genetic component underlying the development and progression of lumbar spine diseases. However, the heritability and the concordance rates for the phenotypes requiring surgery for the common spine diseases lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH) are unknown. The aim of this study was to determine the heritability and the concordance rates for LSS and LDH requiring surgery by studying monozygotic (MZ) and dizygotic (DZ) twin pairs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients between 18 and 85 years of age who underwent surgery for LSS or LDH between 1996 and 2022 were identified in the national Swedish spine registry (LSS: 45,110 patients; LDH: 39,272 patients), and matched with the Swedish Twin Registry to identify MZ and DZ twins. Pairwise and probandwise concordance rates, heritability estimates, and MZ\/DZ concordance ratios were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 414 twin pairs (92 MZ and 322 DZ pairs) of whom 1 or both twins underwent surgery for LSS. The corresponding number for LDH was 387 twin pairs (118 MZ and 269 DZ pairs). The probandwise concordance rate for LSS requiring surgery was 0.25 (26 of 105) (95% confidence interval [CI], 0.14 to 0.34) for MZ twins and 0.04 (12 of 328) (95% CI, 0.01 to 0.07) for DZ twins. The corresponding values for LDH requiring surgery were 0.03 (4 of 120) (95% CI, 0 to 0.08) and 0.01 (4 of 271) (95% CI, 0 to 0.04), respectively. The probandwise MZ\/DZ concordance ratio was 6.8 (95% CI, 2.9 to 21.5) for LSS and 2.3 (95% CI, 0 to 8.9) for LDH. The heritability was significantly higher in LSS compared with LDH (0.64 [95% CI, 0.50 to 0.74] versus 0.19 [95% CI, 0.08 to 0.35]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our findings suggest that genetic factors may play an important role in the risk of developing LSS requiring surgery, whereas heredity seems to be of less importance in LDH requiring surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00902","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T14:02:39Z","timestamp":1708610559000},"page":"891-895","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Surgically Treated Degenerative Lumbar Spine Diseases in Twins"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5654-0660","authenticated-orcid":false,"given":"Lilla","family":"Szigethy","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Orebro University Hospital, Orebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7376-4664","authenticated-orcid":false,"given":"Freyr G.","family":"Sigmundsson","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orebro University Hospital, Orebro, Sweden"},{"name":"Orebro University School of Medical Sciences, Orebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7931-9617","authenticated-orcid":false,"given":"Anders","family":"Joelson","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orebro University Hospital, Orebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"issue":"8","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1177\/2192568218770769","article-title":"Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume","volume":"8","author":"Ravindra","year":"2018","journal-title":"Global Spine J."},{"issue":"1","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1080\/078538902317338634","article-title":"Genetic risk factors for lumbar disc disease","volume":"34","author":"Ala-Kokko","year":"2002","journal-title":"Ann Med."},{"issue":"12","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"3505","DOI":"10.1002\/art.38823","article-title":"Lumbar spinal stenosis is a highly genetic condition partly mediated by disc degeneration","volume":"66","author":"Batti\u00e9","year":"2014","journal-title":"Arthritis Rheumatol."},{"issue":"23","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1097\/01.brs.0000146457.83240.eb","article-title":"Lumbar disc degeneration: epidemiology and genetic influences","volume":"29","author":"Batti\u00e9","year":"2004","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/01.bpo.0000229974.78565.cc","article-title":"Trends in adolescent lumbar disk herniation","volume":"26","author":"Frino","year":"2006","journal-title":"J Pediatr Orthop."},{"issue":"3","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2106\/JBJS.J.00276","article-title":"Evidence for an inherited predisposition to lumbar disc disease","volume":"93","author":"Patel","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.spinee.2013.07.437","article-title":"Genome-wide association studies of lumbar disc degeneration\u2014are we there yet?","volume":"14","author":"Eskola","year":"2014","journal-title":"Spine J."},{"issue":"8","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"2263","DOI":"10.1097\/j.pain.0000000000002221","article-title":"Genome-wide association studies of low back pain and lumbar spinal disorders using electronic health record data identify a locus associated with lumbar spinal stenosis","volume":"162","author":"Suri","year":"2021","journal-title":"Pain."},{"issue":"11","key":"bib9-20250430","doi-asserted-by":"crossref","first-page":"830","DOI":"10.2106\/JBJS.22.00872","article-title":"Identification of Novel Genetic Markers for the Risk of Spinal Pathologies: A Genome-Wide Association Study of 2 Biobanks","volume":"105","author":"Bovonratwet","year":"2023","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib10-20250430","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.2106\/00004623-199511000-00004","article-title":"Similarities in degenerative findings on magnetic resonance images of the lumbar spines of identical twins","volume":"77","author":"Batti\u00e9","year":"1995","journal-title":"J Bone Joint Surg Am."},{"issue":"9","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1097\/00007632-199805010-00013","article-title":"Familial predisposition for lumbar degenerative disc disease. 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