Abstract Osteoporotic vertebral fractures are common among ageing populations worldwide. Although small vertebral size has been established as an independent risk factor for vertebral fracturing, relatively few determinants of vertebral size are currently known. The present study aimed to reveal lifetime factors that associate with midlife vertebral size. Overall physical activity across the lifespan, sports participation in adulthood, occupational physical activities in adulthood, and physical growth in early life were investigated. A subsample of the Northern Finland Birth Cohort Study 1966 was used, with a 46-year follow-up (n = 1,540). Vertebral dimensions were obtained by magnetic resonance imaging of the lumbar spine at the age of 46. The present data showed that high lifelong leisure-time physical activity and active participation in high-impact sports in adulthood were associated with large midlife vertebral size among women, but no such association was detected among men. Occupational physical activities were not associated with vertebral size among either sex. Early-life weight gain predicted large midlife vertebrae among both sexes, and the effect of height gain on vertebral size seemed to be mediated by adult height. The present findings show that the female vertebra in particular seems to benefit from high leisure-time physical activity and active participation in high-impact sports. Regardless of sex, early development also seems to play a role in determining later-life vertebral size. Prospective studies should confirm the causality of the present findings, and further research is needed to shed light on other lifetime factors as determinants of vertebral size. / Tiivistelmä Selkänikaman osteoporoottiset murtumat ovat maailmanlaajuisesti yleinen ikääntyvän väestön vaiva. Pienen nikamakoon tiedetään lisäävän nikamamurtuman riskiä, mutta nikamakokoon vaikuttavia tekijöitä tunnetaan toistaiseksi varsin vähän. Tämän tutkimuksen tavoitteena on selvittää keski-iän nikamakokoon vaikuttavia elinaikaisia tekijöitä. Erityisesti tutkitaan vapaa-ajan liikunnallisuuden, lajikohtaisen harrastusaktiivisuuden, työn liikunnallisten piirteiden sekä lapsuuden ja nuoruuden fyysisen kehityksen yhteyttä nikamakokoon. Tutkimusjoukkona käytetään osaotosta Pohjois-Suomen vuoden 1966 syntymäkohortista (n = 1 540). Seuranta-aika on ollut 46 vuotta, ja selkänikaman koko on määritetty tutkittavista 46 vuoden iässä otetuista lannerangan magneettikuvista. Tutkimusaineistossa naisten elinaikainen vapaa-ajan liikunnallisuus sekä aktiivinen luustoa kuormittavien liikuntalajien harrastaminen ovat yhteydessä suureen nikamakokoon keski-iässä. Miesten liikunnallisuuden ja nikamakoon välillä ei sen sijaan havaittu vastaavaa yhteyttä, eivätkä työn liikunnalliset piirteet olleet yhteydessä nikamakokoon kummallakaan sukupuolella. Varhainen painon kasvu ennusti suurta keski-iän nikamakokoa sukupuolesta riippumatta, ja varhaisen pituuskasvun vaikutus nikamakokoon näytti välittyvän aikuispituuden kautta. Tutkimuksen tulosten perusteella siis erityisesti naiset näyttäisivät hyötyvän vapaa-ajan liikunnallisesta aktiivisuudesta ja luuta kuormittavien lajien harrastamisesta aikuisiällä. Sukupuolesta riippumatta myös lapsuuden ja nuoruuden fyysisellä kehityksellä näyttäisi olevan merkitystä keski-iän nikamakokoon. Tulevaisuudessa prospektiivisten tutkimusasetelmien tulisi vahvistaa tässä tutkimuksessa havaittujen yhteyksien kausaliteetti. Lisäksi tutkimusta tarvittaisiin jatkossa muiden nikamakokoon vaikuttavien elinaikaisten tekijöiden selvittämiseksi.

<p>Uvod: Sindrom lumbalne radikulopatije obuhvata disfunkciju nervnog korena lumbalne kičme, prouzrokovano kompresijom, nastalom usled hernijacije (protruzije, prolapsa) intervertebralnog diska ili zbog inflamatornih i degenerativnih promena (najče&scaron;će osteofita) u foraminalnom otvoru. Kvalitet života predstavlja savremeni koncept posmatranja ishoda oboljenja i uspe&scaron;nosti terapijske procedure kako u svim oblastima medicine, tako i u problematici lumbalne radikulopatije.<br />Cilj: Proceniti kvalitet života operativno i neoperativno lečenih pacijenata sa lumbalnom radikulopatijom na početku lečenja i 3 meseca, odnosno 6 meseci nakon sprovedene medicinske rehabilitacije.<br />Metode: Istraživanje predstavlja prospektivnu kliničku studiju kojom je analiziran kvalitet života bolesnika sa lumbalnom radikulopatijom. Obuhvaćen je randomiziran i stratifikovan uzorak pacijenata sa lumbalnom radikulopatijom diskalne geneze starosti 20 do 65 godina, oba pola (n=100), lečenih u Specijalnoj bolnici za progresivne mi&scaron;ićne i neuromi&scaron;ićne bolesti Novi Pazar. Jedna grupa ispitanika (n=50) lečena je isključivo neoperativnim metodama, dok je druga grupa bolesnika (n=50) lečena hirur&scaron;kim i neoperativnim metodama. Kod svih pacijenata sproveden je konzervativni tretman primenom fizikalnih procedura, kineziterapijskih procedura, ergonomske edukacije. Medikamentna terapija je kod svih bila identična. Za procenu stanja pacijenata, kvaliteta života i efekta rehabilitacionog tretmana kori&scaron;ćena su dva standardizovana upitnika: op&scaron;ti zdravstveni upitnik Medical Outcomes Study Short Form 36 (SF 36) i upitnik specifičan za oboljenje The Oswestry Disability Index (ODI).<br />Rezultati: Vrednosti SF-36 upitnika prikazanih sumarnim fizičkim (SFS) i mentalnim (SMS) skorom, i kod neoperativno lečenih ispitanika (FSFS=450,221 i p&lt;0,001; FSMS=106,543 i p&lt;0,001), ali i kod operativno lečenih (FSFS=490,721 i p&lt;0,001; FSMS=72,055 i p&lt;0,001) značajno su se menjale u toku ispitivanja. Vrednosti SFS kod neoperativno lečenih pacijenata (početak tretmana, 3 meseca, 6 meseci): 35,5 / 44,7 / 50,8; kod operativno lečenih: 28,8 / 42,8 / 49,2. Vrednosti SMS kod neoperativno lečenih pacijenata: 40,6 / 44,8 / 52,6; kod operativno lečenih: 37,8 / 45,2 / 52,5.<br />Najveće pobolj&scaron;anje SFS, kod obe grupe pacijenata, je registrovano u prva tri meseca od početka rehabilitacionog tretmana, dok je najveći napredak SMS registrovan u prva tri meseca od početka rehabilitacionog tretmana kod druge grupe pacijenata.<br />Vrednosti skora Osvestri indeksa nesposobnosti (ODI), i kod pacijenata prve grupe (F=432,810 i p&lt;0,001), ali i kod pacijenata druge grupe (F=1341,180 i p&lt;0,001) značajno su se menjale u toku ispitivanja. Vrednosti ODI kod neoperativno lečenih pacijenata su: 51,5% / 36% / 22,5%; a kod pacijenata druge grupe: 56,1% / 38,9% / 23,7%. Najveće pobolj&scaron;anje je registrovano u prva tri meseca od početka rehabilitacionog tretmana kod druge grupe pacijenata. Postoje statistički značajne korelacije glavnih sumarnih skorova i domena SF-36 (SFS i SMS) i ODI skorova.<br />Zaključak: Kvalitet života i funkcionalni status i neoperativno i operativno lečenih pacijenata je značajno bolji u komparaciji stanja, na 3 meseca i na 6 meseci u odnosu na početak rehabilitacije, kao i na 6 meseci u odnosu na stanje na 3 meseca.</p> / <p>Introduction: The syndrome of lumbar radiculopathy involves dysfunction of nerve roots of the lumbar spine, caused by compression, resulting due to herniation (protrusion, prolapse) intervertebral disc, or due to inflammatory and degenerative changes (usually osteophytes) in foraminal opening. Quality of life is the modern concept of observing the outcome of disease and therapeutic procedures in performance in all areas of medicine, as well as the problems of lumbar radiculopathy.<br />Aim: Assess the quality of life for surgically and conservatively treated patients with lumbar radiculopathy at initiation of treatment and 3 months, and 6 months after conducting medical rehabilitation.<br />Methods: The study is a prospective clinical study, which analyzed the quality of life of patients with lumbar radiculopathy. Also included is randomized and stratified sample of patients with lumbar radiculopathy of discal genesis aged 20 to 65 years, of both sexes (n=100) treated at the Special Hospital for progressive muscular and neuromuscular diseases Novi Pazar. One group of patients (n=50) were treated exclusively non-surgical methods, while the second group of patients (n=50) treated with surgical and non-surgical methods. In all patients was conducted by applying the conservative treatment of physical procedures, kinesitherapy procedures, ergonomic education. Medication treatment is at all were identical. To assess the condition of patients, quality of life and the effect of rehabilitation treatment used two standardized questionnaires: a general health questionnaire Medical Outcomes Study Short Form 36 (SF 36) and disease-specific questionnaire The Oswestry Disability Index (ODI).<br />Results: Values SF-36 questionnaire presented summary physical (SFS) and mental (SMS) scores, with non-surgical treated subjects (FSFS=450.221, p&lt;0.001; FSMS=106.543, p&lt;0.001), but also at surgical treated (FSFS=490.721, p&lt;0.001; FSMS=72.055, p&lt;0.001) were significantly changed during the study. Values at SFS non-surgical treated patients (beginning of treatment, 3 months, 6 months): 35.5 / 44.7 / 50.8; at surgical treated: 28.8 / 42.8 / 49.2. Values SMS with the non-surgical treated patients: 40.6 / 44.8 / 52.6; with surgical treated: 37.8 / 45.2 / 52.5. The biggest improvement of SFS, in both groups of patients were registered in the first three months of the start of the rehabilitation treatment, while the biggest progress SMS is registered in the first three months of the start of treatment in other patient groups. The Oswestry Disability Index (ODI) values score, in patients of the first group (F=432.810, p&lt;0.001), and in second group of patients (F=1341.180, p&lt;0.001) were significantly changed during the study. ODI values at non-surgical treated patients were: 51.5% / 36% / 22.5%; the second group of patients: 56.1% / 38.9% / 23.7%. The bigest improvement was registered in the first three months of the start of treatment in second group patients. There are statistically significant correlations main summary scores and SF-36 domains (SFS and SMS) and ODI scores.<br />Conclusion: The quality of life and functional status of both groups patients was significantly better in comparison to the situation, at 3 months and 6 months compared to the beginning of rehabilitation, as well as at 6 months compared to 3 months.</p>