Different spinal subtypes with varying characteristics of lumbar disc degeneration at specific level with age: a study based on an asymptomatic population

Abstract

Background: The relationship between spinal sagittal subtypes and lumbar disc degeneration is unclear. Thus, we aimed to investigate the relationship between lumbar intervertebral disc degeneration and age in asymptomatic healthy individuals with different sagittal alignments. Methods: In this cross-sectional observational study, we examined 209 asymptomatic young and middle-aged volunteers (123 women and 86 men) who were divided into the following three groups according to age: groups A (20-30 years), B (31-40 years), and C (41-50 years). The volunteers underwent full-spine standing lateral radiography and magnetic resonance imaging (MRI, 3.0 T) of the lumbar spine. Based on panoramic radiography, two observers measured the spinopelvic parameters and classified the spine into Roussouly subtypes. The degree of disc degeneration was assessed based on T2-weighted images according to the Pfirrmann classification. Results: There was a statistically significant difference in the degree of degeneration of type I spine between groups B and C at L4-L5 (P < 0.03) and L5-S1 (P < 0.01) and between groups A and C at L1-L2 (P < 0.04) and L4-L5 (P < 0.01). The degeneration degree of type II spine at all levels were significantly different between groups A and C. No statistically significant difference was found between groups A and B in all subtypes except for type II spine at L1-L2 (P < 0.04). A significant difference was found at four levels between groups B and C in type III spine (P < 0.05) and between groups A and C. For type IV spine, there was a significant difference in the degree of degeneration at L4-L5 (P < 0.02) between groups A and C. Moreover, almost all single parameters were not strongly correlated with the degree of disc degeneration. Conclusion: The different spinal subtypes have characteristics of lumbar disc degeneration at specific levels with age. We considered that spinal classification could be used as a predictor of lumbar disc degeneration. Our data may be helpful to increase awareness of the relationship between spinal subtypes and lumbar disc degeneration.

Existe alguma associação entre gravidade de degeneração discal e dor lombar?

“…These findings raise the hypothesis that lower degrees of degeneration in higher lumbar discs produce a more pronounced pain effect and a greater impact on clinical dysfunction and quality of life. A previous study 31 demonstrated that disc degeneration in the upper lumbar spine is more frequent in certain types of spine curvature or certain types of posture, with rectification of the thoracolumbar transition. These situations cause an overload on the disc, and, due to the anatomical configuration of the lumbar spine, there is a smaller dispersion of forces on the disc to the articular facets and other support structures.…”

“…Esses achados levantam a hipótese de que graus menores de degeneração em discos lombares mais altos produzem um efeito álgico mais acentuado e um maior impacto na disfunção clínica e na qualidade de vida. Um estudo anterior 31 demonstrou que a degeneração discal na coluna lombar alta é mais frequente em certos tipos de curvatura da coluna ou certos tipos de postura, com retificação da transição toracolombar. Essas situações propiciam uma sobrecarga no disco, e, devido à configuração anatômica da coluna lombar alta, há uma menor dispersão das forças sobre o disco para as facetas articulares e as demais estruturas de sustentação.…”

Comprehensive Treatment of Discopathies of the Lumbar Spine

“…On average, the incidence of degenerative disc disease is equally common in both men and women of up to 50 years of age. However, the first signs appear earlierat about 25-35 years [2].…”

Existe correlação entre grau de degeneração discal e lombalgia?

“…Alguns autores já haviam atentado para a ocorrência de maior degeneração do D.I. L1-L2 em determinados padrões de equilíbrio sagital, com retificação da transição toracolombar64 .…”