Prevalence of Cervical and Thoracic Spinal Disease: A Systematic Review

Abstract

Objective: This study aimed to comprehensively assess the prevalence and distribution of degenerative cervical and thoracic diseases with compression of the spinal cord, such as disc herniation (TDH) or hypertrophied ligamentum flavum causing stenosis, by reviewing the literature. Methods: We searched PubMed/MEDLINE to identify articles on the prevalence of degenerative diseases with compression of the spinal cord in the cervical and thoracic spine. The levels of evidence were classified according to the NASS 2005 method. We selected articles containing information on the prevalence of degenerative cervical and thoracic diseases.Results: We identified 358 articles. Thirty-eight met our criteria, with evidence ranging from levels I to V. The prevalence of asymptomatic spinal cord compression lesions was found to be relatively high in elderly people with underlying conditions. Non-traumatic spinal cord injuries are caused by various degenerative diseases involving spinal cord compression, such as cervical myelopathy, ossification of the posterior longitudinal ligament, and ossification of the ligamentum flavum, and are observed in more than 50% of patients with lesions in Japan and the United States, more than 30% in Europe, and more than 20% in Australia. Regarding thoracic lesions, a prevalence of 5% to 10% has been reported for various spinal cord compression lesions such as herniated disc, ossification of the posterior longitudinal ligament, and ossification of the ligamentum flavum.Conclusion: Spinal cord compressive lesions appear not to be rare in the cervical and thoracic spine. The radiographic findings of various stenotic lesions must be well understood and correlated with clinical symptoms before treatment decisions.