Abstract
Objectives: Radiographic assessment of cervical spine can help find the etiology of neck symptoms, however association between these findings is debatable. The aim of this study was to investigate the association between degenerative changes of the cervical spine and symptomatic cervical disc herniation. Patients and Methods: This cross-sectional retrospective study included 160 patients who underwent anterior cervical discectomy and fusion between February 2012 and June 2017 for cervical disc herniation. Demographic data, patients’ symptoms and radiographic findings and indices were evaluated. The Chi-Square (X2) and one-way ANOVA were used to compare the observed data. Results: A total of 160 patients were studied. Among them, 83 (52%) were male and 77(48%) were female. The patients were classified into four groups on the basis of imaging findings: 89(55.6%) with degenerative changes and symptomatic disc herniation at the same level (group 1), 40(25%) with degenerative changes at a level adjacent to symptomatic level (group 2), 23(14.3%) with symptomatic herniation both at the degenerated level and at level immediately adjacent to it (group 3), and 8(5%) symptomatic herniation and degenerative changes at non-adjacent levels (group 4). There were no significant differences among the four groups from the viewpoint of gender, age, symptoms, smoking and sedentary life style. The study also showed no significant differences between groups with respect to Ishihara index, disc height and posterior osteophyte length. Conclusion: Degenerative changes visible on neck X-ray can be useful clues to the symptomatic disc herniation, but disc herniation may also develop at adjacent and non-adjacent levels.
Highlights
Incidence and prevalence of cervical disc herniation are not clear
The patients were classified into four groups on the basis of imaging findings: 89(55.6%) with degenerative changes and symptomatic disc herniation at the same level, 40(25%) with degenerative changes at a level adjacent to symptomatic level, 23(14.3%) with symptomatic herniation both at the degenerated level and at level immediately adjacent to it, and 8(5%) symptomatic herniation and degenerative changes at non-adjacent levels
The study showed no significant differences between groups with respect to Ishihara index, disc height and posterior osteophyte length
Summary
Incidence and prevalence of cervical disc herniation are not clear. Degenerative changes are commonly found in cervical spine imaging but often occur in asymptomatic individuals as well as those with neck pain[1]. The prevalence of degenerative changes in asymptomatic individuals increase from 37% of 20-year-old individuals to 96% of 80-year-old individuals. The relationship between these changes and symptomatic cervical disc herniation are not well stated[2,3]. We sought to investigate the association between degenerative changes observed in cervical spine X-Ray and symptomatic disc herniation
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