Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 1;45(19):1341-1347.
doi: 10.1097/BRS.0000000000003548.

Disc Degeneration of Young Low Back Pain Patients: A Prospective 30-year Follow-up MRI Study

Simo Sääksjärvi  1   2 , Liisa Kerttula  3 , Katariina Luoma  1   4 , Hannu Paajanen  5 , Eero Waris  1   2
Affiliations

Disc Degeneration of Young Low Back Pain Patients: A Prospective 30-year Follow-up MRI Study

Simo Sääksjärvi et al. Spine (Phila Pa 1976). .

Abstract

Study design: A prospective follow-up study.

Objective: The aim of this study was to investigate whether early lumbar disc degeneration (DD) in young low back pain (LBP) patients predicts progression of degenerative changes, pain, or disability in a 30-year follow-up.

Summary of background data: MRI is an accurate method for studying degenerative changes in intervertebral discs. Decreased signal intensity (SI) can be used as indication of decreased water content. Long-term prognosis of early DD remains unclear.

Methods: In an earlier study, 75 conscripts aged 20 years with LBP had their lumbar spine examined by MRI. At a follow-up of 30 years, the subjects were contacted; 35 of 69 filled a pain and disability questionnaire, and 26 of 35 were also reexamined clinically and by MRI. The images were evaluated for decreased SI and other degenerative changes. Association between decreased SI of a disc at baseline and the presence of more severe degenerative changes in the same disc space at follow-up was analyzed using Fisher exact test. Association between decreased baseline SI and pain/disability scores from the questionnaire was analyzed with Kruskal-Wallis H test.

Results: The total number of lumbar discs with decreased SI increased from 23 of 130 (18%) to 92 of 130 (71%)-from 0.9 to 3.5 per subject during the follow-up. Distribution of DD changed from being mostly in L4-L5 and L5-S1 discs to being almost even between the four lowermost discs. Discs that had even slightly decreased SI at baseline were more likely to have severely decreased SI at follow-up, compared to healthy discs (57% vs. 11%, P < 0.001). Other degenerative changes were also more common in these discs. Severity of DD at baseline did not have a significant association with current pain or disability.

Conclusion: In young LBP patients, early degeneration in lumbar discs predicts progressive degenerative changes in the respective discs, but not pain, disability, or clinical symptoms.

Level of evidence: 4.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Heistaro S, Arokoski J, Kröger H. Kaila-Kangas L, et al. Back pain and chronic low-back syndrome. Musculoskeletal Disorders and Diseases in Finland.. Helsinki, Finland: National Public Health Institute; 2007. 14–18.
    1. Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin 2007; 25:353–371.
    1. Erkintalo MO, Salminen JJ, Alanen AM, et al. Development of degenerative changes in the lumbar intervertebral disk: Results of a prospective MR imaging study in adolescents with and without low-back pain. Radiology 1995; 196:529–533.
    1. Tertti M, Paajanen H, Laato M, et al. Disc degeneration in magnetic resonance imaging. A comparative biochemical, histologic, and radiologic study in cadaver spines. Spine (Phila Pa 1976) 1991; 16:629–634.
    1. Modic MT, Steinberg PM, Ross JS, et al. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 1988; 166 (1 pt 1):193–199.