European Spine Journal

, Volume 27, Issue 5, pp 1119–1126 | Cite as

Risk factors of non-specific spinal pain in childhood

  • Julia Szita
  • Sara Boja
  • Agnes Szilagyi
  • Annamaria Somhegyi
  • Peter Pal Varga
  • Aron LazaryEmail author
Original Article



Non-specific spinal pain can occur at all ages and current evidence suggests that pediatric non-specific spinal pain is predictive for adult spinal conditions. A 5-year long, prospective cohort study was conducted to identify the lifestyle and environmental factors leading to non-specific spinal pain in childhood.

Materials and methods

Data were collected from school children aged 7–16 years, who were randomly selected from three different geographic regions in Hungary. The risk factors were measured with a newly developed patient-reported questionnaire (PRQ). The quality of the instrument was assessed by the reliability with the test–retest method. Test (N = 952) and validity (N = 897) datasets were randomly formed. Risk factors were identified with uni- and multivariate logistic regression models and the predictive performance of the final model was evaluated using the receiver operating characteristic (ROC) method.


The final model was built up by seven risk factors for spinal pain for days; age > 12 years, learning or watching TV for more than 2 h/day, uncomfortable school-desk, sleeping problems, general discomfort and positive familiar medical history (χ2 = 101.07; df = 8; p < 0.001). The probabilistic performance was confirmed with ROC analysis on the test and validation cohorts (AUC = 0.76; 0.71). A simplified risk scoring system showed increasing possibility for non-specific spinal pain depending on the number of the identified risk factors (χ2 = 65.0; df = 4; p < 0.001).


Seven significant risk factors of non-specific spinal pain in childhood were identified using the new, easy to use and reliable PRQ which makes it possible to stratify the children according to their individual risk.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Back pain Risk factor Risk assessment Questionnaires and surveys Prevention 



The authors would like to thank the school teachers for their help in subject recruitment. We are grateful to Mária Tóth and Rita Füzi from the National Public Health and Medical Officer Services for their valuable support during the project. We also thank Jessica Böröcz Quittard for providing English language corrections.

Funding sources

The research leading to these results received funding from the European Community’s GENODISC Programme under grant agreement no. HEALTH-F2-2008-201626.

Compliance with ethical standards

Conflict of interest

None of the authors have any potential conflict of interest.

Ethical approval

The study was approved by Hungary’s Scientific and Research Ethics Committee of the Medical Research Council (431/PI/2007).

Informed consent

All participants’ parents/legal guardians received study information and signed an informed consent form.

Supplementary material

586_2018_5516_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 26 kb)
586_2018_5516_MOESM2_ESM.pptx (137 kb)
Supplementary material 2 (PPTX 137 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.National Center for Spinal DisordersBudapestHungary
  2. 2.School of Ph.D. StudiesSemmelweis UniversityBudapestHungary

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