J Korean Neurosurg Soc.  2013 Jan;53(1):31-38. 10.3340/jkns.2013.53.1.31.

Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 1 : Lumbar Spine

• Kim SJ
• Lee TH
• Lim SM

• KMID: 2066982
• DOI: http://doi.org/10.3340/jkns.2013.53.1.31

Abstract

OBJECTIVE
Asymptomatic patients show high degeneration prevalence at lumbar disc in previous literatures. Unfortunately, there are few Korean data, so the authors attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI.
METHODS
We performed 3 T MRI sagittal scans from T12 to S1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for lumbar disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification.
RESULTS
The prevalence of HN, AF, and ND were 81.4%, 76.1%, and 75.8% respectively. Almost all levels showed an age-related proportional tendency with some exceptions.
CONCLUSION
In asymptomatic Korean subjects, the abnormal findings showed high prevalence of AF, ND, and extrusion. Especially in young ages, the authors found that bulging, protrusion, and AF showed high prevalence at L4/5 and L5/S1. And ND showed high prevalence at L5/S1. So, all lumbar disc degenerations are not pathologic, especially in children and adolescents.

Keyword

Degeneration; Lumbar disc; Magnetic resonance imaging

MeSH Terms

Adolescent
Child
Humans
Intervertebral Disc Degeneration
Magnetic Resonance Imaging
Male
Prevalence
Spine

Figure

• 

  Fig. 1 References of image for disc degeneration are shown. The criteria of classification are described in Table 2 and 3. A : Herniation. G0, normal. G1, diffuse bulging. G2, protrusion. G3, extrusion. B : Annular fissure. G0, normal. G1, annular fissure at posterior or posterolateral site. G2, annular fissure at anterior site. G3, annular fissure at anterior and posterior site. C : Nucleus degeneration. G0, normal. G1, normal disc height and hyperintense nucleus signal with horizontal dark band. G2, decreased disc height and hyperintense nucleus signal with or without horizontal dark band. G3, normal disc height and decreased nucleus signal with slightly or heterogeneous irregularity. G4, slightly decreased disc height and decreased nucleus signal with slightly or heterogeneous irregularity. G5, moderately decreased disc height and decreased nucleus signal with moderately. G6, collapsed disc height and hypointense nucleus signal.

• 

  Fig. 2 Graph of disc degeneration prevalence according to age and level, calculated by disc count. A, B and C : Herniation. D : Annular fissure. E : High-signal intensity zone (HIZ). F : Nucleus degeneration.

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