Magnetic Resonance Study of Disc Degeneration in Young Low-Back Pain Patients

Paajanen, Hannu; Erkintalo, Minna; Kuusela, Timo; Dahlström, Seppo; Kormano, Martti

doi:10.1097/00007632-198909000-00012

Cited by 117 publications

(72 citation statements)

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“…Disc degeneration occurred in 30% of asymptomatic subjects, in agreement with other series [6,18]. Degeneration, as seen on MRI, must therefore be interpreted with caution and does not necessarily collate with LBR However, one study [21], comparing young adult males with healthy controls, found that LBP patients had an increased incidence of degenerative disease. In this particular study, it is noteworthy that two extreme study groups were considered: patients referred to hospital for LBP and men who had never experienced LBR In contrast, none of the subjects in the present study were imaged because they had sought medical advice and all were actively working.…”

Section: Discussionsupporting

confidence: 85%

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The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males

1997

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The purpose of this study was to undertake a critical review of the potential role of magnetic resonance imaging (MRI) in the evaluation of low back pain (LBP) and to determine if there were differences in the MRI appearances between various occupational groups. The study group, 149 working men (78 aged 20-30 years and 71 aged 31-58 years) from five different occupations (car production workers, ambulance men, office staff, hospital porters and brewery draymen), underwent MRI of the lumbar spine. Thirty-four percent of the subjects had never experienced LBR Twelve months later, the examination was repeated on 89 men. Age-related differences were seen in the MRI appearances of the lumbar spine. Disc degeneration was most common at L5/S 1 and was significantly more prevalent (P < 0.01) in the older age group (52%) than in the younger age group (27%). Although LBP was more prevalent in the older subjects there was no relationship between LBP and disc degeneration. No differences in the MRI appearance of the lumbar spine were observed between the five occupational groups. Overall, 45% had 'abnormal' lumbar spines (evidence of disc degeneration, disc bulging or protrusion, facet hypertrophy, or nerve root compression). There was not a clear relationship between the MRI appearance of the lumbar spine and LBR Thirtytwo percent of asymptomatic subjects had 'abnormal' lumbar spines and 47% of all the subjects who had experienced LBP had 'normal' lumbar spines. During the 12-month follow-up period, 13 subjects experienced LBP for the first time. However, there was no change in the MRI appearances of their lumbar spines that could account for the onset of LBR Although MRI is an excellent technique for evaluating the lumbar spine, this study shows that it does not provide a suitable pre-employment screening technique capable of identifying those at risk of LBR

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Section: Discussionsupporting

confidence: 85%

“…Despite the extraordinary ability of MRI to delineate the spine, this study suggests that there is not a clear relationship between the MRI appearance and LBR This conclusion is supported by several other investigations [6,10,12,15,18,21]. The causes of LBP are numerous, diverse and poorly understood.…”

Section: Discussionmentioning

confidence: 46%

The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males

1997

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“…van Tulder et al [50] performed a systematic review and reported that lumbar disc degeneration is a risk factor for low back pain in adults. Several studies have shown an association between degenerative disc disease and low back pain [16,39,48]. Some researchers have suggested a causal relationship between early-onset degenerative disc disease and recurrent low back pain throughout a patient's lifetime [45,46].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

McCunniff

Yoo

Dugarte

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Cadaveric studies have examined disc degeneration at the L4-L5 and L5-S1 motion segments; however, we are not aware of another study that has examined the relationship between bilateral spondylolysis and its effect on degenerative disc disease at those levels. This may have been overlooked by researchers owing to the majority of spondylolysis occurring at the L5 vertebra. Questions/purposes Using osteologic specimens from a collection that included individuals who died in one city in the USA between 1893 and 1938, we asked: (1) do specimens with bilateral spondylolysis (bilateral pars defects) have increased levels of disc degeneration, at their respective motion segments, when compared with matched controls without spondylolysis, and (2) is the finding of a bilateral pars defect associated with more severe arthritis at L4-L5 than at L5-S1? Methods An observational study was performed on 665 skeletal lumbar spines from the Hamann-Todd Osteologic Collection at the Cleveland Museum of Natural History (Cleveland, OH, USA). The specimens included 534 males and 131 females ranging from 17 to 87 years old, with a nearly bell-shaped distribution of ages for males and a larger proportion of younger ages in the female specimens. Of those with spondylolysis, 81 had a defect at L5 and 14 had a defect at L4. The gross specimens were examined subjectively for evidence of arthrosis. At the time of examination, specific attention was not paid to the coexisting presence or absence of spondylolysis nor was the examiner blinded to the age of the specimens. Disc degeneration was measured by the classification of Eubanks et al., a modified version of the Kettler and Wilke classification. Linear regression was performed to derive a formula that would predict the amount of disc degeneration at L4-L5 and L5-S1 for the normal control population given a specimen's age, sex, and race. We then used this formula to evaluate the difference in disc degeneration at the corresponding level of the pars defect that is greater Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at the University Hospitals Case Medical Center and the Cleveland Museum of Natural History, Cleveland, OH, USA. P. T. McCunniff (&), Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® than the pr...

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“…In order to ensure the two groups were comparable, therefore, they were compared for age and sex distribution, number and level of segments fused, and grade of degeneration on magnetic resonance (MR) images (graded as 1-4 using a modification of the classification proposed by Paajanen [41] (Table 1). …”

Section: Methodsmentioning

confidence: 99%

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

Madan

Boeree

2003

European Spine Journal

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Magnetic Resonance Study of Disc Degeneration in Young Low-Back Pain Patients

Cited by 117 publications

References 0 publications

The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males

The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

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