Cent Eur J Public Health 2017, 25(3):245-250

Level of Education as a Risk Factor for Extensive Prevalence of Cervical Intervertebral Disc Degenerative Changes and Chronic Neck Pain

Vedran Markotić¹, Damir Zubac², Miro Miljko³, Goran Šimić⁴, Amra Zalihić³, Gojko Bogdan¹, Dorijan Radančević¹, Ana Dugandžić Šimić⁴, Josip Mašković¹

¹ Department of Clinical Radiology, University Hospital, Mostar, Bosnia and Herzegovina

² Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia

³ School of Medicine, University Hospital in Mostar, Mostar, Bosnia and Herzegovina

⁴ University Hospital, Mostar, Bosnia and Herzegovina

Objective: The aim of this study was to document the prevalence of degenerative intervertebral disc changes in the patients who previously reported symptoms of neck pain and to determine the influence of education level on degenerative intervertebral disc changes and subsequent chronic neck pain.

Methods: One hundred and twelve patients were randomly selected from the University Hospital in Mostar, Bosna and Herzegovina, (aged 48.5 ± 12.7 years) and submitted to magnetic resonance imaging (MRI) of the cervical spine. MRI of 3.0 T (Siemens, Skyrim, Erlangen, Germany) was used to obtain cervical spine images. Patients were separated into two groups based on their education level: low education level (LLE) and high education level (HLE). Pfirrmann classification was used to document intervertebral disc degeneration, while self-reported chronic neck pain was evaluated using the previously validated Oswestry questionnaire.

Results: The entire logistic regression model containing all predictors was statistically significant, (χ²(3) = 12.2, p = 0.02), and was able to distinguish between respondents who had chronic neck pain and vice versa. The model explained between 10.0% (Cox-Snell R²) and 13.8% (Nagelkerke R²) of common variance with Pfirrmann classification, and it had the strength to discriminate and correctly classify 69.6% of patients. The probability of a patient being classified in the high or low group of degenerative disc changes according to the Pfirrmann scale was associated with the education level (Wald test: 5.5, p = 0.02). Based on the Pfirrmann assessment scale, the HLE group was significantly different from the LLE group in the degree of degenerative changes of the cervical intervertebral discs (U = 1,077.5, p = 0.001).

Conclusion: A moderate level of intervertebral disc degenerative changes (grade II and III) was equally matched among all patients, while the overall results suggest a higher level of education as a risk factor leading to cervical disc degenerative changes, regardless of age differences among respondents.

Keywords: education, disc degeneration, cervical vertebra, chronic neck pain

Received: August 8, 2016; Revised: November 23, 2016; Published: October 10, 2017  Show citation