Ruangchainikom Monchai, Daubs Michael D, Suzuki Akinobu, Xiong Chengjie, Hayashi Tetsuo, Scott Trevor P, Phan Kevin, Wang Jeffrey C
Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Orthopedic Surgery, University of California Los Angeles, Los Angeles, CA, USA.
Asian Spine J. 2021 Dec;15(6):799-807. doi: 10.31616/asj.2020.0325. Epub 2020 Dec 28.
Cross-sectional study.
To evaluate lumbar disc degeneration (LDD) on magnetic resonance imaging (MRI) in symptomatic subjects to accumulate baseline data on the pattern of degeneration.
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.
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.
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.
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.
横断面研究。
在有症状的受试者中通过磁共振成像（MRI）评估腰椎间盘退变（LDD），以积累退变模式的基线数据。
LDD在患者腰痛的诊断和治疗中起重要作用。很少有研究关注LDD的模式以了解腰椎的老化过程。
本研究纳入了1095例接受腰椎直立位MRI检查的患者（平均年龄44.29岁；范围16 - 85岁）。LDD分为五类（I - V级）。阳性LDD定义为III级及以上。分析LDD的患病率和模式，并评估年龄与LDD总分级之间的相关性。
LDD的平均节段数和总分级随年龄增加。LDD随年龄向头侧移动。在LDD患病率出现前的十年中，LDD发生率迅速上升并超过50%。在单节段LDD组中，L5 - S1节段是最常见的节段（60.3%）。在双节段组中，L4 - L5和L5 - S1节段是最常见的节段（53.5%）。在三节段组中，L3 - L4、L4 - L5和L5 - S1节段是最常见的节段（55.7%）。在多节段LDD组中，连续多节段椎间盘退变（CMDD）比跳跃节段椎间盘退变（SLDD）更常见。L4 - L5节段是CMDD组中最常见的节段，而L5 - S1节段是SLDD组中最常见的节段。
发现LDD与年龄相关，LDD的具体模式和发生率取决于腰椎间盘节段和年龄。这些LDD模式数据可在脊柱手术前用于预测LDD随年龄自然进展的可能性。
