Asian Spine J.
2021 Dec;15(6):799-807. 10.31616/asj.2020.0325.
Patterns of Lumbar Disc Degeneration: Magnetic Resonance Imaging Analysis in Symptomatic Subjects
- Affiliations
-
- 1Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- 2Department of Orthopedic Surgery, University of California Los Angeles, Los Angeles, CA, USA
- 3Department of Orthopedic Surgery, School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
- 4Department of Orthopaedic Surgery, Faculty of Medicine, Osaka City University, Osaka, Japan
- 5Department of Orthopaedic Surgery, General Hospital of the Central Theater Command of the People’s Liberation Army, Wuhan, China
- 6Department of Orthopaedic Surgery, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Fukuoka, Japan
- 7Proliance Orthopedics and Sports Medicine, Bellevue, WA, USA
- 8Department of Orthopedic Surgery, Montefiore Medical Center, New York, NY, USA
- 9USC Spine Center, Department of Orthopedic Surgery, Faculty of Medicine, University of Southern California, Los Angeles, CA, USA
- KMID: 2523380
- DOI: http://doi.org/10.31616/asj.2020.0325
Abstract
- Study Design: Cross-sectional study.
Purpose: To evaluate lumbar disc degeneration (LDD) on magnetic resonance imaging (MRI) in symptomatic subjects to accumulate baseline data on the pattern of degeneration.
Overview of Literature: LDD plays an important role in the diagnosis and treatment of low-back pain in patients. Few studies have focused on the pattern of LDD to understand how the lumbar spine ages.
Methods
This study included 1,095 patients (mean age, 44.29 years; range, 16–85 years) who underwent upright lumbar MRI. LDD was graded into five categories (I–V). Positive LDD was defined as grade III or greater. The prevalence and pattern of LDD were analyzed, and the correlations between age and total grade of LDD were evaluated.
Results
The average number of LDD levels and the total grade of LDD increased with age. LDD moved cephalad with age. The rate of LDD increased rapidly during the decade before the prevalence of LDD and became >50%. In the single-level LDD group, the levels L5–S1 were the most common levels (60.3%). In the two-level group, L4–L5 and L5–S1 were the most common levels (53.5%). In the three-level group, L3–L4, L4–L5, and L5–S1 were the most common levels (55.7%). In the multilevel LDD group, contiguous multilevel disc degeneration (CMDD) was more common than the skipped level disc degeneration (SLDD). The levels L4–L5 were the most common levels in the CMDD group, and L5–S1 were the most common levels among SLDD.
Conclusions
LDD was found to correlate with age, and the specific patterns and rates of LDD depended on lumbar disc level and age. These LDD pattern data can be used before spinal procedures to predict the probability of natural LDD progression with age.
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