Prevalence of cervical spine degenerative changes in elderly population and its weak association with aging, neck pain, and osteoporosis

Abstract

Background: To investigate the prevalence of MRI degenerative findings of cervical spine in elderly Chinese males and females.

Methods: From a general population sample, cervical spine T2 weighted sagittal MR images were acquired in 272 males (mean age: 82.9±3.83) and 150 females (mean age: 81.5±4.27). Images were interpreted and degenerative changes were classified. Study subjects were divided into younger group (group A, ≤81 years) and older group (group B, >81 years). For neck pain, question was structured as 'during the past 12 months, have you had any neck pain?'. Two hundred and fifty-two males and 134 females also had hip bone mineral density (BMD) measured.

Results: 98.1% subjects exhibited at least one degenerative change at one or more vertebral levels. The C5/6 level had the highest overall frequency for degenerative changes. Most of the degenerative changes were more common in females. The older female group had higher prevalence or higher severity of degenerative findings than the younger group. Eleven point four percent of the males and 20.6% of the females reported neck pain, and male subjects with neck pain tended to have slightly higher prevalence of cervical degenerative changes. There was a weak trend that osteoporosis was associated with a higher prevalence of spinal cord high signal and a higher prevalence of spinal canal stenosis.

Conclusions: The age-dependence of cervical spine degenerative changes was more notable in females. Subjects with neck pain and subjects with osteoporosis were weakly associated with higher prevalence of cervical degenerative changes.

Keywords: Cervical spine; MRI; aging; degenerative changes; neck pain.

Figure 1

An illustration of cervical spine degenerative changes evaluated on MRI.

Figure 2

Cervical spine level-specific degenerative findings. Degenerative findings are overall slightly more frequent in females than in males, particularly for spinal cord high signal and vertebral body compressive deformity. M, males; F, females. G1, grade-1; G2, grade-2; G3, grade-3; Cl-1, class-1; Cl-2, class-2.

Figure 3

Age’ effect on cervical spine degenerative findings. Positive values indicate higher prevalence in the older groups (B). Females’ older group (pink or red colored bars) tends to consistently show positive values except grade-1 canal narrowing (but positive for grade-2 canal narrowing), Schmorl node and disc protrusion (class-2). Depending on the degeneration types, the trend for males (light blue or blue colored bars) is less consistent (more details see Table S1). G1, grade-1; G2, grade-2; G3, grade-3; Cl-1, class-1; Cl-2, class-2.