医学
坐骨神经痛
磁共振成像
腰痛
腰椎
变性(医学)
人口
无症状的
背痛
椎间盘
椎间盘
放射科
外科
病理
环境卫生
替代医学
作者
Kenneth M.C. Cheung,Jaro Karppinen,Danny Chan,Daniel Wai‐Hung Ho,You‐Qiang Song,Pak Sham,Kathryn S.E. Cheah,J. C. Y. Leong,Keith D. K. Luk
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2009-04-01
卷期号:34 (9): 934-940
被引量:700
标识
DOI:10.1097/brs.0b013e3181a01b3f
摘要
In Brief Study Design. A cross-sectional population study of magnetic resonance imaging (MRI) changes. Objective. To examine the pattern and prevalence of lumbar spine MRI changes within a southern Chinese population and their relationship with back pain. Summary of Background Data. Previous studies on MRI changes and back pain have used populations of asymptomatic individuals or patients presenting with back pain and sciatica. Thus, the prevalence and pattern of intervertebral disc degeneration within the population is not known. Methods. Lumbar spine MRIs were obtained in 1043 volunteers between 18 to 55 years of age. MRI changes including disc degeneration, herniation, anular tears (HIZ), and Schmorl’s nodes were noted by 2 independent observers. Differences were settled by consensus. Disc degeneration was graded using Schneiderman’s classification, and a total score (DDD score) was calculated by the summation of the Schneiderman’s score for each lumbar level. A K-mean clustering program was used to group individuals into different patterns of degeneration. Results. Forty percent of individuals under 30 years of age had lumbar intervertebral disc degeneration (LDD), the prevalence of LDD increasing progressively to over 90% by 50 to 55 years of age. There was a positive correlation between the DDD score and low back pain. L5–S1 and L4–L5 were the most commonly affected levels. Apart from the usual patterns of degeneration, some uncommon patternsof degeneration were identified, comprising of subjects with skip level lesions (intervening normal levels) and isolated upper or mid lumbar degeneration. Conclusion. LDD is common, and its incidence increases with age. In a population setting, there is a significant association of LDD on MRI with back pain. This large scale population study of magnetic resonance imaging changes of the lumbar spine between the ages of 18 and 55 years showed that lumbar intervertebral disc degeneration was found to be common and age dependent. Magnetic resonance imaging changes of degeneration are associated with low back pain. Some unusual patterns of degeneration were identified.
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