MINI: We performed a population-based retrospective cohort study that included 950 cases with lumbar puncture (LP) and 1876 matched control without LP, the proportion of degenerative disc disease (DDD) diagnosis… Click to show full abstract
MINI: We performed a population-based retrospective cohort study that included 950 cases with lumbar puncture (LP) and 1876 matched control without LP, the proportion of degenerative disc disease (DDD) diagnosis was 20.5% with LP vs 16.4% without LP corresponding to a hazard ratio of 1.33 (95%CI 1.10-1.60; p = 0.003). STUDY DESIGN A population-based, retrospective cohort study. OBJECTIVE To determine whether Lumbar puncture (LP) is associated with risk of degenerative disc disease (DDD) progression. SUMMARY OF BACKGROUND DATA Etiology of DDD is poorly understood and has been suggested to be multifactorial, with pro-inflammatory cytokine mediators playing a pathophysiological role. While it is known that LP is associated with local inflammation, a clear link has not been previously established between LP and DDD. METHODS In this study, we performed a population-based matched cohort analysis using the medical records linkage system of the Rochester Epidemiology Project to investigate this possible association. Between 2004 and 2009, a total of 950 cases who underwent LP and 1876 referent subjects (who did not undergo an LP procedure), matched by age, sex and BMI were identified. Univariate and multivariable Cox proportional hazards analyses were used to estimate the risk of DDD among patients undergoing LP. RESULTS The cumulative probability of developing DDD from the time of LP procedure was 13.8% among LP cases (95% CI 11.5%-16.1%) vs. 9.4% among controls (95%CI 8.1%-10.8%) at 5 years. On multivariable Cox regression analysis, patients undergoing an LP were found to have a significantly higher risk of developing DDD (HR 1.33; 95%CI 1.10-1.60; p = 0.003). Use of fluoroscopic guidance while performing an LP was associated with a significantly lower risk of DDD (OR 0.55, 95% CI 0.30, 1.00, p value = 0.049) when compared to patients who did underwent LP without fluoroscopy. CONCLUSION This investigation is the first to demonstrate a possible link between LP and higher risk of developing DDD. In addition, we show that using image-guided LP might attenuate that risk. LEVEL OF EVIDENCE 4.
               
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