Chadha Manish, Srivastava Amit, Kumar Vipin, Tandon Anupama
Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095 India.
Department of Radio-Diagnosis, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095 India.
Indian J Orthop. 2022 Mar 20;56(6):1083-1089. doi: 10.1007/s43465-022-00619-2. eCollection 2022 Jun.
This descriptive cross-sectional observational study aimed to investigate the prevalence of various types of disc degeneration in the lumbar spine of asymptomatic young adults. The disc degeneration of lumbar spine could be due to age-related physiological changes than to pathological changes in asymptomatic people. Due to the ethnic and racial differences in lifestyle, it is proposed that the prevalence of disc degeneration in the normal population in different region of the world would differ. There are scarce data on the Indian population on the same.
Fifty individuals between 15 and 30 years of age, with no history of low back pain undergoing MR imaging for spinal pathology other than the lumbar spine, were included in the study. Various abnormalities (herniation HN, annular fissure AF, nuclear degeneration ND) were recorded and their prevalence was calculated by disc counts (DC) and person count (PC). DC is the number of discs with degeneration and PC is the number of patients with disc degeneration.
56% asymptomatic individuals were found to have either HN or AF or ND at one or more levels. The DC of disc degeneration was 20.8% and it was most commonly observed in L4-L5 intervertebral disc (38%) followed by L5-S1 disc (30%). Thirteen individuals had disc degeneration at single level, 12 at two levels and 3 individuals at all the five lumbar intervertebral disc levels.
The current study showed a high prevalence of disc degeneration (either HN, AF or ND) in young asymptomatic individuals. Even if the MRI shows disc degeneration, patients can be asymptomatic and one needs to correlate the symptoms with the MRI. The limitations of the current study are small numbers of patients from a localized geographical area; hence, we recommend a larger multi-centric study as a follow-up.
本描述性横断面观察性研究旨在调查无症状年轻成年人腰椎中各种类型椎间盘退变的患病率。在无症状人群中,腰椎间盘退变可能是由于与年龄相关的生理变化而非病理变化所致。由于生活方式存在种族和民族差异,因此有人提出世界不同地区正常人群中椎间盘退变的患病率会有所不同。关于印度人群的相关数据很少。
本研究纳入了50名年龄在15至30岁之间、无腰痛病史且因腰椎以外的脊柱病变接受磁共振成像检查的个体。记录各种异常情况(椎间盘突出HN、环状裂隙AF、髓核退变ND),并通过椎间盘计数(DC)和个体计数(PC)计算其患病率。DC是指发生退变的椎间盘数量,PC是指患有椎间盘退变的患者数量。
发现56%的无症状个体在一个或多个节段存在HN或AF或ND。椎间盘退变的DC为20.8%,最常见于L4-L5椎间盘(占38%),其次是L5-S1椎间盘(占30%)。13名个体在单个节段发生椎间盘退变,12名在两个节段,3名在所有五个腰椎间盘节段均发生退变。
本研究显示年轻无症状个体中椎间盘退变(HN、AF或ND)的患病率很高。即使磁共振成像显示椎间盘退变,患者也可能无症状,需要将症状与磁共振成像结果相关联。本研究的局限性在于来自局部地理区域的患者数量较少;因此,我们建议进行更大规模的多中心研究作为后续研究。