Frequency of Disc Degeneration at Different Levels of Cervical Vertebrae in Adult Patients with Neck Pain on Magnetic Resonance Imaging

Background:Disc degeneration is terminology used for heterogeneous changes affecting the anatomy and physiology of the intervertebral disc. Disc degeneration alters the material properties of the intervertebral disc leading to an unfavorable distribution and transmission of stress to adjacent spinal structures.Objective:The aim of the study was to determine the frequency of disc degeneration at different level of cervical vertebrae in adult patients with neck pain on magnetic resonance imaging.Methodology:In this descriptive study 180 adult patients were included. All patients had been collected from DHQ hospital Gilgit and Ghurki Trust teaching hospital. After informed consent, data were collected through 1.5 tesla GE (closed bore) and 0.35 tesla Hitachi (open bore) MRI machines.Results:Findings show that among 180 adult patients, 136 presented with disc degeneration among which 81 were males and 55 were females. Among 81 males, 63 had disc degeneration at multiple levels while 18 had single disc degeneration. In females 35 patients showed multiple disc degeneration while 20 involved a single disc.Conclusion:It is concluded that disc degeneration is prevalent in males than females. Disc degeneration at multiple levels is higher than single disc degeneration in both genders. Keywords: Disc degeneration, magnetic resonance imaging, intervertebral disc. DOI: 10.7176/JHMN/71-02 Publication date: February 29th 202

Evaluation of Cervical Disc Degeneration in Patients with Neck Pain on Magnetic Resonance Imaging

Background: Cervical disc degeneration is the most common pathology that in most of the cases  clinically present as Objective: To evaluate the cervical region abnormalities in patients with neck pain on magnetic resonance imaging. Methodology: In this descriptive study 180 adult patients were included. All patients had been collected from DHQ hospital Gilgit and Ghurki Trust teaching hospital. After informed consent, data were collected through 1.5 tesla GE (closed bore) and 0.35 tesla Hitachi (open bore) MRI machines. Results:  Findings show that among 180 adult patients, 136 presented with disc degeneration among which 81 were males and 55 were females. Among 81 males, 63 had disc degeneration at multiple levels while 18 had single disc degeneration. In females 35 patients showed multiple disc degeneration while 20 involved a single disc. Conclusion: It is concluded that disc degeneration is prevalent in males than females. Disc degeneration at multiple levels is higher than single disc degeneration in both genders. Keywords: Disc degeneration, magnetic resonance imaging. DOI: 10.7176/JHMN/99-03 Publication date: April 30th 2022

Are patterns of lumbar disc degeneration associated with low back pain? New insights based on skipped level disc pathology

Free Papers: Spine ‐ Lumbar: abstract no. 29648INTRODUCTION: The clinical relevance of 'patterns' of disc degeneration of the lumbar spine is unknown. In the setting of multilevel disc degeneration (2 or more levels), this study addressed the clinical implications of skipped level disc degeneration (SLDD) to that of consecutive, multilevel disc degeneration (CMDD) of the lumbar ...poatprin

A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status

Background: Little is known regarding juvenile disc degeneration in individuals with normal spinal alignment. Consequently, the purpose of this study was to assess the prevalence, determinants, and clinical relevance associated with juvenile disc degeneration of the lumbar spine in individuals without spinal deformities. Methods: A cross-sectional assessment of disc degeneration in juveniles was performed as part of a population-based study of 1989 Southern Chinese volunteers. Adolescents and young adults from thirteen to twenty years of age were defined as "juveniles." Juvenile subjects with no spinal deformity (n = 83) were stratified into two groups, those with and those without juvenile disc degeneration. Sagittal T2-weighted magnetic resonance images (MRI) were evaluated for the presence and extent of disc degeneration as well as other spinal findings. Demographics were assessed and clinical profiles were collected with use of standardized questionnaires. Results: Juvenile disc degeneration was present in 35% (twenty-nine) of the juveniles without spinal deformity. Disc bulging or extrusion (p < 0.001), high-intensity zones on MRI (p = 0.040), and greater weight (p < 0.001) and height (p = 0.002) were significantly more prevalent in subjects with juvenile disc degeneration. Adjusted multivariate logistic regression modeling demonstrated that Asian-modified body-mass index (BMI) values in the overweight or obese range had a significant association with juvenile disc degeneration (odds ratio = 14.19; 95% confidence interval = 1.44 to 140.40; p = 0.023). Overweight and obese individuals had greater severity of disc degeneration than underweight and normal-weight individuals (p = 0.036). Furthermore, individuals with juvenile disc degeneration had an increased prevalence of low back pain and/or sciatica (p = 0.002), greater low back pain intensity (p < 0.001), diminished social functioning (p = 0.049), and greater physical disability (p < 0.05) than individuals without disc degeneration. The p value of <0.05 for physical disability represents both the physical function (p = 0.006) and the physical component (p = 0.032) of the SF-36. Conclusions: This study demonstrated that the presence of juvenile disc degeneration was strongly associated with overweight and obesity, low back pain, increased low back pain intensity, and diminished physical and social functioning. Furthermore, an elevated BMI was significantly associated with increased severity of disc degeneration. This study has public health implications regarding overweight and obesity and the development of lumbar disc disease. Copyright © 2011 by the journal of bone and joint surgery, incorporated.published_or_final_versio

Experimental intervertebral disc degeneration models

Intervertebral disc degeneration is a major health problem of close concern to both young and old. The problem is also growing as the global population ages. Intervertebral disc degeneration is defined as progressive changes affecting the spine as a component of natural aging under the effect of multiple factors (such as smoking, obesity, and incorrect exercise). For a solution to be found, experimental disc degeneration must first be induced, the causes of the disease must be identified, and early diagnostic and therapeutic methods must then be developed. Methods of inducing intervertebral disc degeneration with high applicability in rats were identified from the previous literature. This review discusses four methods of disc degeneration induction. It also discusses how to detect degeneration formation and development times. As a result of the literature review, information about four different and reliable intervertebral disc degeneration methods is presented

A novel magnetic resonance imaging postprocessing technique for the assessment of intervertebral disc degeneration-Correlation with histological grading in a rabbit disc degeneration model.

Introduction:Estimation of intervertebral disc degeneration on magnetic resonance imaging (MRI) is challenging. Qualitative schemes used in clinical practice correlate poorly with pain and quantitative techniques have not entered widespread clinical use. Methods:As part of a prior study, 25 New Zealand white rabbits underwent annular puncture to induce disc degeneration in 50 noncontiguous lumbar discs. At 16 weeks, the animals underwent multi-echo T2 MRI scanning and were euthanized. The discs were stained and examined histologically. Quantitative T2 relaxation maps were prepared using the nonlinear least squares method. Decay Variance maps were created using a novel technique of aggregating the deviation in the intensity of each echo signal from the expected intensity based on the previous rate of decay. Results:Decay Variance maps showed a clear and well demarcated nucleus pulposus with a consistent rate of decay (low Decay Variance) in healthy discs that showed progressively more variable decay (higher Decay Variance) with increasing degeneration. Decay Variance maps required significantly less time to generate (1.0 ± 0.0 second) compared with traditional T2 relaxometry maps (5 (±0.9) to 1788.9 (±116) seconds). Histology scores correlated strongly with Decay Variance scores (r = 0.82, P &lt; .01) and weakly with T2 signal intensity (r = 0.32, P &lt; .01) and quantitative T2 relaxometry (r = 0.39, P &lt; .01). Decay Variance had superior sensitivity and specificity for the detection of degenerate discs when compared to T2 signal intensity or Quantitative T2 mapping. Conclusion:Our results show that using a multi-echo T2 MRI sequence, Decay Variance can quantitatively assess disc degeneration more accurately and with less image-processing time than quantitative T2 relaxometry in a rabbit disc puncture model. The technique is a viable candidate for quantitative assessment of disc degeneration on MRI scans. Further validation on human subjects is needed

Frequency of Disc Degeneration at Different Levels of Lumbar Vertebrae in Adult Patients with Backache on Magnetic Resonance Imaging

Objective:To Determine the Frequency of Disc Degeneration at Different Levels of lumbar Vertebrae in Adult Patients with lower back Pain on Magnetic Resonance Imaging. Study Design: An analytical cross-sectional descriptive study was performed. Settings: The study was performed in Bashir Neurospine Institute and Al-Razi Healthcare center, Lahore. Period: An Analytical cross sectional study was conducted from 15 October,2020 to 15 January 2021. Material and Methods: In our study, all those adult patients with lower back pain, obese, dull ache, numbness, tingling, pins and needle sensations, muscles spasms were included. And those patients who were not giving consent, spondylosis, lumbar spine stenosis, cervical and thoracic abnormalities, paedes, and those who were uncooperative were excluded. Data was tabulated and analyze with the help of statistical package for the social science (SPSS version 24). The data was reported using cross sectional descriptive statistics. Results: In our research out of 160 patients 89 females and 51 males were those who  diagnosed with disc degeneration and 10 females and 10 male in which disc degeneration was absent. 10 patients out of 160 patients were those who diagnosed with disc degeneration at the level of L1 - L2 between the age of 24 to 87, 8 patients were those in which disc degeneration present at the level of L2- L3 between the age of 43 to 87, 31 patients were those in which disc degeneration present at the level of L3-L4 and  96 patients diagnosed with  disc degeneration present at the level of L4- L5 which is the lowest lumbar vertebra between the age of 55 to 80 years. Overall out of 160 patients only 3 patients were those who represent with mild pain (25yrs) and 102 were those who came with moderate pain (27-90yrs) and 55 patients who represent with severe backache (30 to 89yrs). In this research out of 160(100%) patients only 102  patients (63%) are those who present with moderate pain and 55 patients (34%)with severe pain .At L1-L2   disc degeneration only 5 patients (50%) were those who came with moderate and 5( 50% )with severe pain. At L2-L3 disc degeneration two patients (25%) with moderate and six patients (75%)with severe pain .At L3-L4 disc degeneration 11 patients (35.4%) with moderate and 20(64.5%) with severe pain. At L4-L5 disc degeneration 51 patients (53%) with moderate pain and 45 patients (46.8%) with severe pain. Our study also revealed that elevated BMI patients had high frequency of disc degeneration. Conclusion: This study conclude that lumbar disc degeneration was approximately in women than men who were represented with lower back pain. Minority of patients had normal lumbar MRI findings. Most of the degeneration occurs at the lowest lumbar vertebrae i.e. L4- L5 and patients who were presented with elevated BMI have increased risk of disc degeneration. Keywords: Lumbar vertebrae, Magnetic resonance imaging, lower back pain. Degenerative disc disease. DOI: 10.7176/JHMN/90-17 Publication date:June 30th 2021

Associations between clinical neck symptoms and various evaluations ofcervical intervertebral disc degeneration by magnetic resonance imaging

Purpose: Magnetic resonance imaging (MRI) is widely used to evaluate intervertebral disc degeneration. Recently, various evaluations of cervical disc degeneration using MRI have been conducted, but there is no gold standard. The purpose of this study was to compare the reproducibilities of previously reported classifications for evaluating cervical disc degeneration by MRI and their associations with clinical symptoms. Participants and methods: A total of 582 subjects underwent conventional MRI of the cervical spine. Disc degeneration was assessed in each intervertebral disc from C2/3 to C7/T1 using five different classifications: Matsumoto's grading system, Miyazaki's grading system, Nakashima's grading system, Jacobs' grading system, and Suzuki's grading system. MR images of 30 participants were used, and Cohen's kappa coefficient of agreement of each classification was calculated for intra-observer and inter-observer reliabilities. These five classifications of disc degeneration and changes of vertebral endplates were measured, and associations with clinical symptoms were assessed. Results: Kappa (κ) values of intra-observer agreement were higher for Jacobs' classification, whereas those of inter-observer agreement were higher for Nakashima's and Jacobs' classifications than for other classifications. The prevalences of neck pain and shoulder stiffness were 27.4% and 41.9%, respectively. There were no associations for any classifications of disc degeneration and Modic types with neck pain or shoulder stiffness. Only the presence of Schmorl's nodes was associated with neck pain. Conclusion: At present, there is no specific classification for cervical disc degeneration associated with clinical symptoms. Vertebral endplate changes might be associated with clinical symptoms. It may be necessary to create a new classification for better reproducibility of the evaluation of cervical disc degeneration

Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

Low back pain as a result of degenerative disc disease imparts a large socioeconomic impact on the health care system. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving stem cells, growth factors, and gene therapy have the theoretical potential to prevent, slow, or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration is essential for the development of treatment strategies that target the underlying mechanisms of disc degeneration rather than the downstream symptom of pain. Such strategies ideally aim to induce disc regeneration or to replace the degenerated disc. However, at present, treatment options for degenerative disc disease remain suboptimal, and development and outcomes of novel treatment options currently have to be considered unpredictable