The authors declare that they have no competing interests.
KA conceived of this study and participated in the study design, and performed data acquisition, analysis and interpretation, and drafted the manuscript. TY participated in the interpretation of data, performed statistical analyses, and critically revised the manuscript. NI developed and programmed the image analysis software, participated in the interpretation of data, and helped to draft the manuscript. AN directed the medical examinations, performed data acquisition, and critically revised the manuscript. AS contributed to the study design and coordination, and helped to draft the manuscript. All authors read and approved the final manuscript.
The progression of disc degeneration is generally believed to be associated with low back pain and/or degenerative lumbar diseases, especially in the elderly. The purpose of this study was to quantitatively evaluate changes in lumbar disc height using radiographic measurements and to investigate risk factors for development of disc height narrowing of the elderly.
From 1997 to 2007, 197 village inhabitants at least 65 years-old who participated in baseline examinations and more than four follow-up examinations conducted every second year were chosen as subjects for this study. Using lateral lumbar spine radiographs of each subject, L1-L2 to L5-S1 disc heights were measured. The subjects were divided into two groups according to the rate of change in disc height: mildly decreased (≤20 % decrease) and severely decreased (>20 % decrease). A stepwise multiple logistic regression analysis was used to select those factors significantly associated with disc height narrowing.
Disc height at each intervertebral disc (IVD) level decreased gradually over ten years (p < 0.01, an average 5.8 % decrease of all disc levels). There was no significant difference in the rate of change in disc height among the IVD levels. Female gender, radiographic knee osteoarthritis and low back pain at baseline were associated with increased risk for disc height narrowing.
We conducted the first population-based cohort study of the elderly that quantitatively evaluated lumbar disc height using radiographic measurements. The risk factors identified in this study would contribute to a further understanding the pathology of disc degeneration.
Muraki S, Akune T, Oka H, En-Yo Y, Yoshida M, Saika A et al. Health-related quality of life in subjects with low back pain and knee pain in a population-based cohort study of Japanese men: the research on osteoarthritis against disability study. Spine. 2011;36(16):1312-9. doi:10.1097/BRS.0b013e3181fa60d1.
Sigmundsson FG, Kang XP, Jonsson B, Stromqvist B. Correlation between disability and MRI findings in lumbar spinal stenosis: a prospective study of 109 patients operated on by decompression. Acta orthopaedica. 2011;82(2):204-10. doi: 10.3109/17453674.2011.566150.
Yong-Hing K, Kirkaldy-Willis WH. The pathophysiology of degenerative disease of the lumbar spine. Orthop Clin North Am. 1983;14(3):491–504. PubMed
Yoshimura N, Dennison E, Wilman C, Hashimoto T, Cooper C. Epidemiology of chronic disc degeneration and osteoarthritis of the lumbar spine in Britain and Japan: a comparative study. J Rheumatol. 2000;27(2):429–33. PubMed
Ikeda Y, Sudo A, Yamada T, Uchida A. Mortality after vertebral fractures in a Japanese population. J Orthop Surg (Hong Kong). 2010;18(2):148-52.
Nishimura A, Hasegawa M, Kato K, Yamada T, Uchida A, Sudo A. Risk factors for the incidence and progression of radiographic osteoarthritis of the knee among Japanese. Int Orthop. 2011;35(6):839-43. doi: 10.1007/s00264-010-1073-x.
Farfan H. Mechanical disorder of the low back. Philadelphia: Lea and Febiger; 1973.
Muraki S, Akune T, Oka H, Ishimoto Y, Nagata K, Yoshida M et al. Incidence and risk factors for radiographic lumbar spondylosis and lower back pain in Japanese men and women: the ROAD study. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. 2012;20(7):712-8. doi: 10.1016/j.joca.2012.03.009.
de Schepper EI, Damen J, van Meurs JB, Ginai AZ, Popham M, Hofman A et al. The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine. 2010;35(5):531-6. doi: 10.1097/BRS.0b013e3181aa5b33.
Wang YX, Griffith JF, Ma HT, Kwok AW, Leung JC, Yeung DK et al. Relationship between gender, bone mineral density, and disc degeneration in the lumbar spine: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system. Osteoporos Int. 2011;22(1):91-6. doi: 10.1007/s00198-010-1200-y.
Wang YX, Griffith JF, Zeng XJ, Deng M, Kwok AW, Leung JC, et al. Prevalence and sex difference of lumbar disc space narrowing in elderly chinese men and women: osteoporotic fractures in men (Hong Kong) and osteoporotic fractures in women (Hong Kong) studies. Arthritis Rheum. 2013;65(4):1004–10. doi: 10.1002/art.37857. CrossRefPubMedPubMedCentral
Wang YX, Griffith JF. Effect of menopause on lumbar disk degeneration: potential etiology. Radiology. 2010;257(2):318-20. doi: 10.1148/radiol.10100775.
Deng M, Griffith JF, Zhu XM, Poon WS, Ahuja AT, Wang YX. Effect of ovariectomy on contrast agent diffusion into lumbar intervertebral disc: a dynamic contrast-enhanced MRI study in female rats. Magn Reson Imaging. 2012;30(5):683-8. doi: 10.1016/j.mri.2012.01.001.
Chapman K, Takahashi A, Meulenbelt I, Watson C, Rodriguez-Lopez J, Egli R, et al. A meta-analysis of European and Asian cohorts reveals a global role of a functional SNP in the 5′ UTR of GDF5 with osteoarthritis susceptibility. Hum Mol Genet. 2008;17(10):1497–504. doi: 10.1093/hmg/ddn038. CrossRefPubMed
Samartzis D, Karppinen J, Mok F, Fong DY, Luk KD, Cheung KM. A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status. J Bone Joint Surg. 2011;93(7):662-70. doi: 10.2106/JBJS.I.01568.
Liuke M, Solovieva S, Lamminen A, Luoma K, Leino-Arjas P, Luukkonen R, et al. Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond). 2005;29(8):903–8. CrossRef
- Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II