Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers

Abstract

There have been few studies that investigated and clarified the relationships between progression of degenerative changes and sagittal alignment of the cervical spine. The objective of the study was to longitudinally evaluate the relationships among progression of degenerative changes of the cervical spine with age, the development of clinical symptoms and sagittal alignment of the cervical spine in healthy subjects. Out of 497 symptom-free volunteers who underwent MRI and plain radiography of the cervical spine between 1994 and 1996, 113 subjects (45 males and 68 females) who responded to our contacts were enrolled. All subjects underwent another MRI at an average of 11.3 years after the initial study. Their mean age at the time of the initial imaging was 36.6 ± 14.5 years (11-65 years). The items evaluated on MRI were (1) decrease in signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk space narrowing. Each item was evaluated using a numerical grading system. The subjects were divided into four groups according to the age and sagittal alignment of the cervical spine, i.e., subjects under or over the age of 40 years, and subjects with the lordosis or non-lordosis type of sagittal alignment of the cervical spine. -009-1095-5 During the 10-year period, progression of decrease in signal intensity of the disk, posterior disk protrusion, and disk space narrowing were recognized in 64.6, 65.5, and 28.3% of the subjects, respectively. Progression of posterior disk protrusion was significantly more frequent in subjects over 40 years of age with non-lordosis type of sagittal alignment. Logistic regression analysis revealed that stiff shoulder was closely correlated with females (P = 0.001), and that numbness of the upper extremity was closely correlated with age (P = 0.030) and male (P = 0.038). However, no significant correlation between the sagittal alignment of the cervical spine and clinical symptoms was detected. Sagittal alignment of the cervical spine had some impact on the progression of degenerative changes of the cervical spine with aging; however, it had no correlation with the occurrence of future clinical symptoms.123 Eur Spine J (2009) 18:1644-1651 DOI 10.1007/s00586

White Matter Organization in Cervical Spinal Cord Relates Differently to Age and Control of Grip Force in Healthy Subjects

“…This suggests both altered axons (accumulations of neurofilaments) and disrupted myelin sheaths, as found in the aging cat (Zhang et al, 1998). Finally, although speculatively, greater age-related effects in the medial spinal cord might be caused by greater compression of the medial compared with the lateral spinal cord because the incidence of posterior disc protrusion increases with age (Okada et al, 2009). In this study, no visual signs of spinal cord stenosis were present among the subjects.…”

Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjects

“…The influence of a developmentally narrow cervical canal on the pathogenesis of spondylotic myelopathy has been emphasized by several workers [1,11]. It is wellknown that subjects with all the radiological features of cervical spondylosis may be symptom free [9], while on the other hand, minimal or moderate radiological changes may induce myelopathy. This discrepancy between radiological changes and the presence of symptoms in cervical spondylosis is attributable mainly due to differences in the initial size of the cervical spinal canal [5,8].…”

“…Degenerative changes in the cervical spine become more common with time and may also present as normal aging variations [9]. Cervical degenerative disease is one of the most common neurological disorders that are being increasingly observed in the geriatric population.…”

Normal morphology, age-related changes and abnormal findings of the cervical spine. Part II: magnetic resonance imaging of over 1,200 asymptomatic subjects

“…Furthermore, the only report we found on normal cervical spinal cord parameters was based on autopsy samples [3]. However, to the best of our knowledge, there have been only a few MRI-based reports describing the normal configuration of the cervical spinal canal, including the soft tissues, and the details of the relationships between the cervical spinal canal, dural tube, and spinal cord [2,6,7]. In the present study, we therefore sought to establish standard MRI values for these parameters in a large sample of healthy asymptomatic subjects.…”