Hiroto Makino1, Yoshiharu Kawaguchi2, Shoji Seki1, Masato Nakano1, Taketoshi Yasuda1, Kayo Suzuki1, Shiro Ikegawa3, Tomoatsu Kimura1. 1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan. 2. Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan. Electronic address: zenji@med.u-toyama.ac.jp. 3. Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan.
Abstract
BACKGROUND: Lumbar disc degeneration (LDD) is known to be the main cause of low back pain, although it is unclear how or when LDD progresses. The purpose of this study was to clarify the process and features of LDD progression in young women. METHODS: We enrolled 480 nursing students and carried out a prospective cohort study in 84 nursing students. MRI of the lumbar spine was taken once during their time as a student and again at 9.8 years (7-14) after the first MRI when they were working as nurses. The grade of LDD was determined according to Schneiderman's grade. The progression of disc degeneration was evaluated by the change in the degenerative disc disease (DDD) score (the summation of DDD score at each disc level). The subjects were divided into two groups based on MRI findings: Group A, those without disc degeneration at the first MRI (n = 58) and Group B, those showing disc degeneration on the first MRI (n = 26). We evaluated the change in DDD score and assessed the particular disc levels that showed Schneiderman's grade worsening in each group. RESULTS: At the time of the 2nd MRI, the DDD score increased from 5.6 (5-9) to 6.3 (5-11). The L5/S disc was the most frequent level showing the progression of LDD. In Group A, 18 subjects (31.0%) and in Group B, 15 subjects (57.7%) had degeneration progression (p = 0.02). CONCLUSIONS: This study revealed that 31% of the young adult subjects already had disc degeneration in 20's (time of first MRI) and the disc degeneration rapidly progressed in these subjects.
BACKGROUND: Lumbar disc degeneration (LDD) is known to be the main cause of low back pain, although it is unclear how or when LDD progresses. The purpose of this study was to clarify the process and features of LDD progression in young women. METHODS: We enrolled 480 nursing students and carried out a prospective cohort study in 84 nursing students. MRI of the lumbar spine was taken once during their time as a student and again at 9.8 years (7-14) after the first MRI when they were working as nurses. The grade of LDD was determined according to Schneiderman's grade. The progression of disc degeneration was evaluated by the change in the degenerative disc disease (DDD) score (the summation of DDD score at each disc level). The subjects were divided into two groups based on MRI findings: Group A, those without disc degeneration at the first MRI (n = 58) and Group B, those showing disc degeneration on the first MRI (n = 26). We evaluated the change in DDD score and assessed the particular disc levels that showed Schneiderman's grade worsening in each group. RESULTS: At the time of the 2nd MRI, the DDD score increased from 5.6 (5-9) to 6.3 (5-11). The L5/S disc was the most frequent level showing the progression of LDD. In Group A, 18 subjects (31.0%) and in Group B, 15 subjects (57.7%) had degeneration progression (p = 0.02). CONCLUSIONS: This study revealed that 31% of the young adult subjects already had disc degeneration in 20's (time of first MRI) and the disc degeneration rapidly progressed in these subjects.
Authors: Anni Aavikko; Martina Lohman; Leena Ristolainen; Hannu Kautiainen; Kalevi Österman; Dietrich Schlenzka; Teija Lund Journal: Eur Spine J Date: 2022-03-25 Impact factor: 2.721