Disc Degeneration/Back Pain and Calcification of the Abdominal Aorta

Kauppila, Leena I.; McAlindon, T.E.; Evans, Stephen; Wilson, Peter W.F.; Kiel, Douglas P.; Felson, David T.

doi:10.1097/00007632-199707150-00023

Cited by 176 publications

(109 citation statements)

References 18 publications

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“…variety of additional potential etiologic factors have been reported, suggesting that the impetus for disc degeneration may be a complex, multifactorial process (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Nonetheless, the effects of such degeneration, if progressive, may lead to the development of low back pain with or without sciatica.…”

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confidence: 99%

“…Although addressing genetic, developmental, or other potential etiologic factors (e.g., environmental, systematic diseases, hormonal) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) that have been suggested to be associated with disc degeneration goes beyond the nature of our study design, one should not dismiss the possibility that such factors may play a role in the manifestation of SLDD. Although a biomechanical component is suggested as contributing to disc degeneration in this context, the suggestion requires further investigation.…”

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Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Cheung¹,

Samartzis²,

Karppinen³

et al. 2010

Arthritis & Rheumatism

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Objective. Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD).Methods. As part of a large genetics-based study in southern Chinese individuals (n ‫؍‬ 1,989), a crosssectional analysis was performed in subjects exhibiting disc degeneration in >2 levels (n ‫؍‬ 838) who were then categorized as having SLDD (n ‫؍‬ 174) or non-SLDD (contiguous, multilevel; n ‫؍‬ 664). Various radiographic parameters were assessed based on T2-weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed.Results. Overall, 8.7% of the whole population (n ‫؍‬ 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n ‫؍‬ 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04-2.10, P ‫؍‬ 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78-4.15, P < 0.001), which also presented in levels with no disc degeneration. A history of disc bulge/extrusion (P ‫؍‬ 0.004) and/or a history of back injury (P ‫؍‬ 0.010) was significantly associated with non-SLDD, and a greater degree of overall severity of disc degeneration was also associated with non-SLDD. Other demographic and MRI findings did not significantly differ between groups.Conclusion. To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration.

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confidence: 99%

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Cheung¹,

Samartzis²,

Karppinen³

et al. 2010

Arthritis & Rheumatism

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“…BP and cardiovascular diseases have been shown to share a number of risk factors [33], and BP has been linked to atherosclerotic changes in the posterior wall of the abdominal aorta in older persons [23]. Probably the most important cause and common denominator for these problems is smoking, which has also been associated with BP in many studies, even though evidence for a direct causal link between the two is lacking [12,25].…”

Section: Discussionmentioning

confidence: 99%

Back pain remains a common symptom in old age. A population-based study of 4486 Danish twins aged 70?102

Hartvigsen

Christensen

Frederiksen

2003

European Spine Journal

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Introduction A recent survey of over 100,000 Medicare beneficiaries aged 65 and older showed that heart and lung disease and back pain (BP) were the most important factors affecting the average physical health status of older Americans [6]. Yet out of the total body of publications on BP, surprisingly little research has focused on BP in old age, and there is an under-representation of the older population in the BP literature [3]. Furthermore, the authors of the most extensive review so far dealing with the prevalence of BP in old age found that results of published studies were difficult to interpret and compare, due to varying definitions of BP among the studies [3]. Consequently, at present it is not known with certainty how common BP is in senior age groups.Little information is also available on the development and prognosis of BP over time late in life. In several cross-sectional studies the prevalence of BP has been estiAbstract Back pain (BP) has been rated among the most important factors affecting physical health status in old age. Yet there is an under-representation of the older population in the BP literature. We present extensive interview data from the Longitudinal Study of Aging Danish Twins, dealing with a population-based sample of Danish twins aged 70-102, and describing the 1-month prevalence of BP and the development of BP over time. The associations between BP and education, self-rated health, other health problems, lifestyle factors, and physical and mental function were also investigated. Data were analysed in a cross-sectional analysis for all answers given at entry into the study and in a longitudinal analysis for participants in all four surveys. Associated factors were analysed for the cross-sectional sample using univariate and multivariate analysis accounting for the non-independence of twins in complete pairs. The overall 1-month prevalence of BP was 25% and differed significantly between men and women. The variations in prevalence between the age groups and over time were negligible. The majority of participants in all four surveys had either not experienced BP during the previous month or had done so on one occasion only. Education was not associated with BP. Self-rated health was associated with BP in a significant "dose-response" like pattern. BP was associated with bone and joint disorders, migraine headaches, lung disease, cardiovascular disorders and gastric ulcer, but not neurologic or endocrinologic diseases. BP sufferers had significantly lower scores on physical but not on mental functioning. We conclude that BP is a common symptom in old age; however, the prevalence does not change with increasing age. BP may be part of a more general syndrome of poor health among the old.

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“…Alterations in the disc's structure may cause back pain and referred pain with or without neurological impairment (3), in addition to significantly compromising the biomechanical integrity of the motion segment (4). While disc degeneration has been implicated as a major etiologic component of low back pain (5,6), there has been relatively little study in developing an objective, accurate, noninvasive diagnostic tool in the detection and quantification of matrix changes in early disc degeneration. Hence, the development of quantitative MR technology could allow early diagnostic and subsequent treatment of disc degeneration and thus reduce incidences of low back pain.…”

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confidence: 99%

Evaluation of quantitative magnetic resonance imaging, biochemical and mechanical properties of trypsin‐treated intervertebral discs under physiological compression loading

Mwale

Demers

Michalek

et al. 2008

Magnetic Resonance Imaging

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Purpose:To investigate the influence of targeted trypsin digestion and 16 hours compression loading on MR parameters and the mechanical and biochemical properties of bovine disc segments. Materials and Methods:Twenty-two 3-disc bovine coccygeal segments underwent compression loading for 16 hours after the nucleus pulposus (NP) of each disc was injected with a solution of trypsin or buffer. The properties of the NP and annulus fibrosus (AF) tissues of each disc were analyzed by quantitative MRI, biochemical tests, and confined compression tests. Results:Loading had a significant effect on the MR properties (T 1 , T 2 , T 1 , MTR, ADC) of both the NP and AF tissues. Loading had a greater effect on the MR parameters and biochemical composition of the NP than trypsin. In contrast, trypsin had a larger effect on the mechanical properties. Our data also indicated that localized trypsin injection predominantly affected the NP. T 1 was sensitive to loading and correlated with the water content of the NP and AF but not with their proteoglycan content. Conclusion:Our studies indicate that physiological loading is an important parameter to consider and that T 1 contributes new information in efforts to develop quantitative MRI as a noninvasive diagnostic tool to detect changes in early disc degeneration.

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Disc Degeneration/Back Pain and Calcification of the Abdominal Aorta

Abstract: Advanced aortic atherosclerosis, presenting as calcific deposits in the posterior wall of the aorta, increases a person's risk for development of disc degeneration and is associated with the occurrence of back pain.

Cited by 176 publications

References 18 publications

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Back pain remains a common symptom in old age. A population-based study of 4486 Danish twins aged 70?102

Evaluation of quantitative magnetic resonance imaging, biochemical and mechanical properties of trypsin‐treated intervertebral discs under physiological compression loading

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