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. 2021 Dec 14;6(4):379-387.
doi: 10.22603/ssrr.2021-0187. eCollection 2022.

Influence of Age and Gender on Intervertebral Disk Degeneration and Height in the Thoracolumbar Spine

Masaaki Machino  1   2 , Hiroaki Nakashima  1   2 , Keigo Ito  2 , Mikito Tsushima  2 , Kei Ando  1 , Kazuyoshi Kobayashi  1 , Shiro Imagama  1
Affiliations

Influence of Age and Gender on Intervertebral Disk Degeneration and Height in the Thoracolumbar Spine

Masaaki Machino et al. Spine Surg Relat Res. .

Abstract

Introduction: Intervertebral disk degeneration is a universal and natural process. However, no reports have summarized anatomical age-related intervertebral disk height and disk degenerative changes in the thoracolumbar spine or examined sex-specific differences. This study aimed to establish age-related changes and gender-specific differences of intervertebral disk height and disk degeneration of the thoracolumbar spine in a large cohort of relatively healthy subjects and also to evaluate the relationship between the degree of thoracolumbar disk height and disk degeneration.

Methods: Six hundred and twenty-seven relatively healthy subjects (307 males and 320 females; average age, 49.6±16.5 years) were enrolled. We included at least 50 males and 50 females in each decade of life between the 20s and the 70s. We measured intervertebral disk height from T10/T11 to L5/S1, vertebral body height from T10 to S1 on lateral neutral radiographs. Lumbar disk degeneration was defined according to the Pfirrmann classification in sagittal plane magnetic resonance imaging.

Results: Age-related decreases in intervertebral disk height were most prominent at L4/L5 in middle-aged and elderly individuals of both sexes. The grade of disk degeneration significantly increased with age in both genders at every level. Mild disk degeneration was observed even in the 20s. The disk degeneration occurred around the L4/L5 level. Although grade V disk degeneration was not identified for males in the 20s and the 30s, it appeared after the 40s and then increased further with age. The intervertebral disk height at the lower lumbar disks decreased with a progression in the disk degeneration grade in both genders.

Conclusions: This large-scale cross-sectional analysis of the thoracolumbar spine in relatively healthy subjects demonstrated that lumbar disk height narrowing progresses with age and is correlated with the progression of disk degeneration.

Keywords: age-related and gender differences; disk degeneration; healthy subjects; intervertebral disk height; thoracolumbar spine.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
Algorithm for the grading system and assessment of lumbar disk degeneration grade using the Pfirrmann classification system.
Figure 2.
Figure 2.
Lumbar disk degeneration using the Pfirrmann classification system in each decade in (A) males and (B) females.
Figure 3.
Figure 3.
Relationship between disk index and thoracolumbar disk degeneration grade at each level. Values are expressed as mean±SD. *p<0.05; **p<0.01
See this image and copyright information in PMC

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