Abstract
PurposeThe aims of this study were (1) to determine the prevalence of radiographic cervical disc degeneration in a large population of patients aged from 18 to 97 years; (2) to investigate individually the prevalence and distribution of height loss, osteophyte formation, endplate sclerosis and spondylolisthesis; and (3) to describe the patterns of cervical disc degeneration.MethodsA retrospective study was performed. Standard lateral cervical spine radiographs in standing, neutral position of 1581 consecutive patients (723 males, 858 females) with an average age of 41.2 ± 18.2 years were evaluated. Cervical disc degeneration was graded from C2/C3 to C6/C7 based on a validated quantitative grading system. The prevalence and distribution of radiographic findings were evaluated and associations with age were investigated.Results53.9% of individuals had radiographic disc degeneration and the most affected level was C5/C6. The presence and severity of disc degeneration were found to be significantly associated with age both in male and female subjects. The most frequent and severe occurrences of height loss, osteophyte formation, and endplate sclerosis were at C5/C6, whereas spondylolisthesis was most observed at C4/C5. Age was significantly correlated with radiographic degenerative findings. Contiguous levels degeneration pattern was more likely found than skipped level degeneration. The number of degenerated levels was also associated with age.ConclusionsThe presence and severity of radiographic disc degeneration increased with aging in the cervical spine. Older age was associated with greater number of degenerated disc levels. Furthermore, the correlations between age and the degree of degenerative findings were stronger at C5/C6 and C6/C7 than at other cervical spinal levels.
Highlights
IntroductionCervical intervertebral disc degeneration is one of the most relevant clinical findings which can be extracted from cervical plain radiographs (i.e. X-rays) and has been
Cervical intervertebral disc degeneration is one of the most relevant clinical findings which can be extracted from cervical plain radiographs (i.e. X-rays) and has beenMedical Center, Chicago, IL, USA 4 International Spine Research and Innovation Initiative, RUSH University Medical Center, Chicago, IL, USA 5 Department Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany described before both in symptomatic and asymptomatic people [1,2,3,4,5,6,7,8,9,10,11]
Prevalence and distribution of cervical disc degeneration and associations with age Generally, 53.9% (n = 852; 386 males, 466 females; mean age = 52.3 ± 16.6 years) of all the subjects presented with radiographic cervical disc degeneration, and the prevalence of disc degeneration was not significantly different between males and females (53.4 vs. 54.3%, p = 0.72). 36.8% of the subjects had Grade 1 disc degeneration, 13.7% had Grade 2 and 3.4% had Grade 3
Summary
Cervical intervertebral disc degeneration is one of the most relevant clinical findings which can be extracted from cervical plain radiographs (i.e. X-rays) and has been. Degeneration is most commonly assessed on magnetic resonance imaging (MRI), conventional plain radiography has several advantages over this imaging modality, such as cost-effectiveness, simplicity, as well as the capability of acquiring cervical sagittal alignment under weight-bearing conditions [12, 13]. Knowledge of the characteristics of cervical disc degeneration based on plain radiographs may have relevant implications. It would be helpful to assess the relation between the cervical disc degeneration and clinical symptoms (e.g. neck pain) [11, 15, 16] or the effect of disc. Given the importance of radiographic disc degeneration to be used as a clinical reference, a better and more precise understanding of the characteristics of cervical disc degeneration based on plain radiographs is essential
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