Myelopathy associated with age-related cervical disc herniation: a retrospective review of magnetic resonance images

Abstract

BACKGROUNDCervical intervertebral disc herniation can lead to myelopathy. Aging is an established variable related to spondylotic myelopathy. Studying this association will help in controlling the increase in spondylotic myelopathy with age.OBJECTIVESTo study the association between cervical disc level, its direction, and the frequency of myelopathy with age, and to assess the epidemiology of age-related cervical disc herniation and myelopathy.DESIGNRetrospective review of magnetic resonance (MR) images.SETTINGTertiary referral hospital.PATIENTS AND METHODSWe studied the MR images of adults patients (>18 years of age) referred to our department between 2001 and 2012 for suspected cervical spondylopathy. The direction and severity of herniation and the presence of myelopathy was determined for spinal levels C2 to C7.MAIN OUTCOME MEASURE(S)Relationship between age-related cervical disc herniation and myelopathy.RESULTSWe studied 6584 patient MR images, which included 2402 males (39.1%) and 3737 females (60.9%). The frequency of myelopathy increased with age from 0.6% in patients <20 years of age, reaching 9.1% in patients >70 years of age. The most common level affected by myelopathy was C5–C6. In elderly patients (>60 years), the C3–C4 level became the predominant level affected by myelopathy. Likewise, the frequency of central disc herniation increased significantly (P<.001) with age at all cervical levels. Furthermore, upper cervical levels showed a higher frequency of central disc herniation than lower cervical levels in the elderly.CONCLUSIONThe increased frequency of central disc herniation with age suggest an important, and probably a cause-effect relationship, between herniation and myelopathy.LIMITATIONSWe were unable to access clinical data or electrophysiological studies to correlate with MR image findings.

Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease’s Association with Work

“…Meanwhile, a significant number of asymptomatic disc herniation (DH) cases may be present as well [ 5 , 6 ]. However, these results have been limited to a certain age group, region, occupation, or group and cannot be referred to when evaluating the occurrence distribution in all age groups or the differences in DH incidence between men and women according to age [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ], thereby limiting their generalizability. The limitations of these epidemiological studies are attributed to the lack of analysis of nationwide diagnosis documents which until now had been impossible.…”

Level-specific Perioperative and Clinical Outcome Comparison: Cervical Disk Replacement Versus Anterior Cervical Diskectomy and Fusion at C5-C6 in Patients With Myeloradiculopathy

“…C5-C6 remains the most common cervical region for degenerative disk pathologies. 37 MCID achievement scores were created to help clinicians align outcomes with clinical presentation to better understand the significance of PROMs. 38,39 Our CDR cohort demonstrated markedly increased MCID achievement in disability and physical function at three time points (NDI at 12 weeks and 1 year and SF-12 PCS at 6 months).…”

Success Rate and Complications Associated with the Surgical Treatment of Cervical Spondylosis Myelopathy in Albania.

“…the prevalence of csM is greatly increased with increasing age, and varying from 0.6% among individuals younger than 20 years and peaked to about 9% among those aged 70+ years [1]. The association with age is due to the increasing incidence of central disc herniation with increasing age [1].…”

“…cervical spondylotic myelopathy (csM) is the most common type of a group of degenerative conditions, described with the term Degenerative cervical Myelopathy (DCM) [1,2].…”