The age-dependent occurrence of cervical degenerative changes was studied using 0.1 T MRI in 89 asymptomatic volunteers aged 9 to 63 years. The degree of DD (disc darkening on T2*-weighted images), disc protrusions and prolapses, narrowing of disc spaces, dorsal osteophytes and spinal canal stenosis were assessed. Abnormalities were commoner in older subjects, 62% of being seen in those over 40 years old. In subjects aged less than 30 years there were virtually no abnormalities. DD was the most common abnormality, seen in 10% of discs; 57% DD was in subjects aged over 40. DD at the C5/6 level was the most common finding. No differences in abnormal findings between males and females was observed, nor any statistically significant association between DD and other abnormalities. Thus, DD begins later age in the cervical spine than in the lumbar region. Asymptomatic degenerative changes are common on MRI in the cervical spine after 30 years of age.
Thirty-nine 15-year-old children with low-back pain (LBP) and 39 asymptomatic control children were selected from a population of 1,503 children of the same age for a magnetic resonance imaging study of the lumbar spine. Subjects with LBP were matched with control subjects by age, sex, and school class. Disk degeneration (DD) was present in 15 (38%) of the children with LBP and in 10 (26%) of the control subjects. Lumbar degeneration was most frequently associated with disk protrusion and Scheuermann-type changes. Of assessed structural abnormalities (disk protrusion, Scheuermann-type changes, transitional vertebra, and disk space narrowing), only disk protrusion was more common in children of the LBP group than in control subjects. The authors conclude that DD is a frequent finding among children with LBP at the age of 15 years. Asymptomatic (possibly physiologic) DD also is frequently found in children of this age. Whether DD associated with structural changes predisposes to low-back disorders can be confirmed only by means of a longitudinal follow-up study.
Magnetic resonance imaging (MRI) was performed on 35 young competitive gymnasts and 10 control subjects in order to detect the number of degenerated discs and other lumbar spinal disorders. Lumbar radiographs were obtained from all gymnasts who showed evidence of disc abnormality on MRI. Eleven gymnasts had suffered from episodes of low back pain during exercises and eight were found to have evidence of back trauma. Only 3 of the 35 gymnasts had MRI evidence of degenerated discs associated with Scheuermann's manifestations and spondylolysis. Lumbar radiographs confirmed the diagnosis in these three cases. The results indicate that despite the excessive range of motion and strong axial loading of the lumbar spine that are associated with gymnastic maneuvers, incurable primary damage to the intervertebral discs is uncommon in young gymnasts during growth.
The concurrence of early disc degeneration and abnormal segmental motion in spondylolysis of young low back pain patients (n = 14) was investigated using magnetic resonance imaging (MRI) and flexion-extension radiography. Seven patients with L5 spondylolisthesis had normal discs on MRI and 7 had disc degeneration below the slipped vertebra. The parallel motion, angular mobility and centre of motion were similar in the degenerated discs and in normal discs. The present study shows that in adolescents the motion pattern and hydration of discs associated with spondylolysis and spondylolisthesis are not always abnormal. The early dehydration and degeneration of lumbar discs observed on MRI are not always associated with abnormal mobility of the corresponding motion segment.
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