Simultaneous Disc Herniation in Patients With Multiple Sclerosis

Abstract

Background: Multiple sclerosis (MS) is a chronic autoimmune, inflammatory demyelinating disease of the central nervous system. Commonly, MS patients present with accompanying degenerative vertebral disc diseases. Simultaneous disc herniations situated in the cervical or lumbosacral spine can mimic the clinical symptoms of MS and worsen patients’ quality of life.Objective: to investigate the incidence rate and clinical impact of accompanying disc herniations in patients with MS.Material and methods: Our study covered 330 patients (220 females and 110 males, mean age 40.5±12.4 years) with clinically definite MS, according to McDonald’s criteria. Comprehensive neurological examinations, EDSS (Expanded Disability Status Scale) assessments, and MRI neuroimaging were carried out. Statistical data processing was performed by using the method of variation analysis.Results: Relapsing-remitting MS (RRMS) was diagnosed in 280 patients while 50 patients presented with secondary progressive MS (SPMS). Disc herniation was found in 64 (19.4%) of our patients. Cervical disc pathology was detected in 38 patients (11.5% of the cases) and lumbosacral - in 26 (7.9% of the cases). EDSS scores ranged from 2.5 to 5.5. EDSS evaluation showed statistically significantly worse scores in MS patients with disc herniation comorbidity (p<0, 05).Conclusion: Our own data confirm the assumption that MS patients often present with accompanying degenerative disc pathology. We suggest that comorbidity of disc herniation and MS exert an additional unfavorable effect on patient’s disability and individual quality of life

Exploring Spinal Cord Changes in Multiple Sclerosis Patients Using MRI

“…Furthermore, this study indicates that the incidence of disc degeneration was observed in almost 14% of females and 6% of males diagnosed with MS. These results are consistent with those of Drenska et al [31], who demonstrated that disc herniation was found in 19.4% of MS patients and that women were affected more than men by a ratio of two to one. In addition, the results of the present study accord with the findings of an extensive prospective cohort study of Japanese adults, where cervical disc degeneration disease was present in 26.3% of men and 27.9% of women aged 21-49 years [32].…”

“…Abnormalities in the spinal cord MRI signals, most typically in the cervical cord, have been observed in up to 90% of MS patients [30]. Concurrently, new research indicates that MS patients may experience degenerative changes in their cervical spine more frequently [31,32]. In order to examine the incidence and clinical impact of herniated discs in patients with MS, the hospital documentation of patients treated medically for symptomatic cervical and lumbar disc herniation between 2020 and 2023 to determine the rate of comorbid disc herniation in MS patients was evaluated.…”

“…It might even be detected four years prior to conversion to progressive MS [35]. The primary cause is thought to be Wallerian degeneration due to changes occurring in the brain, not tissue loss due to primary spinal cord disease [31]. Although brain MRI is used in investigating all MS patients, spinal cord MRI is recommended in certain conditions such as (1) clinical suggestion of spinal cord lesion or primary progressive MS, (2) normal brain MRI in patients with MS clinical presentation, and (3) inconclusive brain MRI [26].…”

MRI Markers of Degenerative Disc Disease in Young Patients With Multiple Sclerosis

“…5 Concurrently, recent evidence suggests that cervical spine degenerative changes are more common in MS patients. [6][7][8] While many factors have been implicated in cervical DDD, including disc dehydration due to natural aging and chronic flexion of the neck with increasing use of electronic devices, 9 the role of MS in this disease process is not well understood.…”

Cervical spinal degenerative disease in multiple sclerosis

“…A study in 2017 examined the prevalence of disc dehydration and protrusion in 42 PwMS versus 42 age‐ and sex‐matched controls, and found these abnormalities to be more common in MS [11]. Another study showed a high incidence of disc herniation (19.4%) in 330 PwMS, although no control population was included [12]. It remains unclear whether foraminal and canal stenosis occurs more commonly in MS. A predisposition of PwMS to stenotic SDD has clinical implications, since decompressive surgery may relieve symptoms, and should lead to heightened awareness of SDD when PwMS present with new or progressive neurological symptoms.…”