Tabоo, Z., Sheet, E., Kasim, W. (2023). Anatomical Changes of Intervertebral Disc with Age: MRI Study Using Quantitative Measure. Alustath, 22(3), 332-346. doi: 10.52573/ipmj.2023.181200
Zahraa Abd-Alkader Tabоo; Eman Ghanim. Sheet; Waleed Hazim. Kasim. "Anatomical Changes of Intervertebral Disc with Age: MRI Study Using Quantitative Measure". Alustath, 22, 3, 2023, 332-346. doi: 10.52573/ipmj.2023.181200
Tabоo, Z., Sheet, E., Kasim, W. (2023). 'Anatomical Changes of Intervertebral Disc with Age: MRI Study Using Quantitative Measure', Alustath, 22(3), pp. 332-346. doi: 10.52573/ipmj.2023.181200
Tabоo, Z., Sheet, E., Kasim, W. Anatomical Changes of Intervertebral Disc with Age: MRI Study Using Quantitative Measure. Alustath, 2023; 22(3): 332-346. doi: 10.52573/ipmj.2023.181200

Anatomical Changes of Intervertebral Disc with Age: MRI Study Using Quantitative Measure

Iraqi Postgraduate Medical Journal
Article 15, Volume 22, Issue 3, July 2023, Pages 332-346    PDF (2.53 M)
DOI: 10.52573/ipmj.2023.181200
Authors
Zahraa Abd-Alkader Tabоo* ; Eman Ghanim. Sheet; Waleed Hazim. Kasim
Department оf Anatоmy , Cоllege оf Medicine, University оf Ninevah, Mоsul , Iraq.
Abstract
BACKGROUND:
The intervertebral cartilage supports the human body structurally. It absorbs shock and allows movement between adjacent vertebrae1. This framework deteriorates with age, a physiological consequence of                  the normal aging process.
OBJECTIVE:
To assess alterations that occur between vertebrae of the spinal column from L1 to L5 and to study                 the changes in vertebral height, occurrence of osteophytes in the lumbar spine vertebrae as well as                     the prevalence of ligamentum flavum hypertrophy and other signs of degeneration according to the age and sex.
PATIENTS AND METHODS: 
The cross sectional study was performed  by  examining (600) patients suffering from a sharp pain in               the lumbar region presented at MRI units at Al-Nuiman Hospital in Baghdad and Ibn Sina teaching Hospital in Mosul .
RESULTS:
The peak age incidence was at the age range of (60-69) years for both degeneration and herniation. Below the age of 40 years, there were 46 patients (7.6%) with degeneration and 22 patients (3.6%) with herniation, while over 40 years the figures were 369 patients (61.5%) showed degeneration and 243 patients (40.5%) with herniation respectively. In addition, there are158 patients have both degeneration and hernia at same time. Out of 600 patients, 371(61.83%) of them are females and 229 (38.17%) are males. The man-to-woman ratio is 1 : 1.6. The vast majority of patients showed degeneration and herniation at L4-L5 level being 367 discs (61.1 %) and 163 patients (27.1 %) out of 600 discs located at that level respectively. Decreased height of the disc increases the potential for fundamental framework changes to the disc, bone and connective tissue.
CONCLUSION:
There is a universal impression that age and sex have an influence on the degeneration of disc of lumber spine
 
Keywords
herniation; deterioration in lumbar vertebrae; morphological changes; intervertebral disc height
References
  1. Newell N, Little JP, Christou A, Adams MA, Adam CJ, Masouros SD. Biomechanics of the human intervertebral disc: a reⅵew of testing techniques and results. J Mech Behav Biomed Mater. 2017;69:420–34.
  2. Brzuszkiewicz-Kuźmicka G, Szczegielniak J, Bączkowicz D. Age-related changes in shock absorption capacity of the human spinal column. Clin Interv Aging. 2018;18;13:987-93. doi: 10.2147/CIA.S156298. PMID: 29844665; PMCID: PMC5963482.
  3. Lee BH, Moon SH, Suk KS, Kim HS, Yang JH, Lee HM. Lumbar Spinal Stenosis: Pathophysiology and Treatment Principle: A Narrative Reⅵ Asian Spine J. 2020 ;14:682-93. doi: 10.31616/asj.2020.0472. PMID: 33108834; PMCID: PMC7595829.
  4. Teraguchi, M.; Yoshimura, N.; Hashizume, H.; Yamada, H.; Oka, H.; Minamide, A.; Nagata, K.; Ishimoto, Y.; Kagotani, R.; Kawaguchi, H.; et al. Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal populationbased cohort: The Wakayama Spine Study. Osteoarthr. Cartil. 2017;25:1122–31.
  5. Bettiol NB, Regalo SCH, Cecilio FA, Gonçalves LMN, de Vasconcelos PB, Lopes CGG, Andrade LM, Regalo IH, Siéssere S, Palinkas M. Intervertebral Disc Degeneration: Functional Analysis of Bite Force and Masseter and Temporal Muscles Thickness. Prague Med Rep. 2022;123:101-12. doi: 10.14712/23362936.2022.11. PMID: 35507943.
  6. Machino M, Ito K, Ando K, Kobayashi K, Nakashima H, Kato F, Imagama S. Normative Magnetic Resonance Imaging Data of Age-Related Degenerative Changes in Cerⅵcal Disc Morphology. World Neurosurg. 2021 ;152:e502-11.doi: 10.1016/j.wneu.2021.05.123. Epub 2021 Jun 16. PMID: 34098133.
  7. Dragsbæk L, Kjaer P, Hancock M, Jensen TS. An exploratory study of different definitions and thresholds for lumbar disc degeneration assessed by MRI and their associations with low back pain using data from a cohort study of a general population. BMC Musculoskelet Disord. 2020;21:253. doi: 10.1186/s12891-020-03268-4. PMID: 32303267; PMCID: PMC7165403.
  8. Ashinsky B, Smith H.E, Mauck R.L. , Gullbrand S.E. Intervertebral disc degeneration and regeneration: a motion segment perspective European Cells and Materials. 2021, 41-1473-2262: 370-387 DOI: 10.22203/eCM.v041a24
  9. Farshad M, Cornaz F, Spirig JM, Sutter R, Farshad-Amacker NA, Widmer J. Spondylophyte classification based on biomechanical effects on segmental stiffness. Spine J. 2022 Jun 6:S1529-9430(22)00238-8. doi: 10.1016/j.spinee.2022.06.001. Epub ahead of print. PMID: 35671943.
  10. Yabe Y, Hagiwara Y, tsuchiya M, Onoda Y, Yoshida S, Onoki T, Ishikawa K, Kurosawa D, Murakami E. Factors Associated with Thickening of the Ligamentum flavum on Magnetic Resonance Imaging in Patients with Lumbar Spinal Canal Stenosis. Spine (Phila Pa 1976). 2022;47:1036-41. doi: 10.1097/BRS.0000000000004341. PMID: 35125456.
  11. Wang B, Gao C, Zhang P, Sun W, Zhang J, Gao J. The increased motion of lumbar induces ligamentum flavum hypertrophy in a rat model. BMC Musculoskelet Disord. 2021 ;22:334. doi: 10.1186/s12891-021-04203-x. PMID: 33823825; PMCID: PMC8025532.
  12. 12- Zhu X, Qiu Z, Liu Z, Shen Y, Zhou Q, Jia Y, Sun X, Li S. CT-Guided Percutaneous Lumbar Ligamentum flavum Release by Needle Knife for Treatment of Lumbar Spinal Stenosis: A Case Report and Literature Reⅵ J Pain Res. 2020;13:2073-81. doi: 10.2147/JPR.S255249. PMID: 32884333; PMCID: PMC7434627.
  13. Zielinska N, Podgórski M, Haładaj R, Polguj M, Olewnik Ł. Risk Factors of Intervertebral Disc Pathology—A Point of ⅵew Formerly and Today—A Reⅵ Journal of Clinical Medicine. 2021;10:409. https://doi.org/10.3390/jcm10030409
  14. Wu, G., Liu, Y., Wen, W., Zhang, Y., Tang, R., Gungor, C.& Sesek, R. F.. Morphological Analysis of the Human Lumbar Spine Using Sagittal Magnetic Resonance Imaging. Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2021;10: 59–62. https://doi.org/10.1177/2327857921101026
  15. Neubert A, Fripp J, Engstrom C, Gal Y, Crozier S, Kingsley MI. Validity and reliability of computerized measurement of lumbar intervertebral disc height and volume from magnetic resonance images. Spine J. 2014 ;14:2773-81. doi: 10.1016/j.spinee.2014.05.023. Epub 2014 Jun 11. PMID: 24929060.24- Modic, M.T.; Steinberg, P.M.; Ross, J.S.; Masaryk, T.J.; Carter, J.R. Degenerative disk disease: Assessment of changes in vertebral body marrow with MR imaging. Radiology 1988; 166:193–99.
  16. Teichtahl AJ, Urquhart DM, Wang Y, Wluka AE, O'Sullivan R, Jones G, Cicuttini FM. Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height - a 3.0 T-MRI study. BMC Musculoskelet Disord. 2016 Feb 19;17:92. doi: 10.1186/s12891-016-0934-x. PMID: 26891686; PMCID: PMC4759726.
  17. Yelin E, Weinstein S, King T. The burden of musculoskeletal diseases in the United States. Semin Arthritis Rheum. 2016 ;46:259-60. doi: 10.1016/j.semarthrit.2016.07.013. Epub 2016 Jul 26. PMID: 27519477
  18. Näther P, Kersten JF, Kaden I, Irga K, Nienhaus A. Distribution Patterns of Degeneration of the Lumbar Spine in a Cohort of 200 Patients with an Indication for Lumbar MRI. Int J Enⅵron Res Public Health. 2022 ;19:3721. doi: 10.3390/ijerph19063721. PMID: 35329406; PMCID: PMC8951543.
  19. Kjaer, P., Tunset, A., Boyle, E. et al. Progression of lumbar disc herniations over an eight-year period in a group of adult Danes from the general population – a longitudinal MRI study using quantitative measures. BMC Musculoskelet Disord 17, 26 (2016). https://doi.org/10.1186/s12891-016-0865
  20. Emad Kh. HammoodLumbar Disc Herniation in Adolescents and Young Adults in Erbil Teaching Hospital: A clinical, Radiological and Surgical Study Diyala Journal of Medicine 2017;13: 94-102.
  21. Khashan M, Ofir D, Grundshtein A, Kuzmenko B, Salame K, Niry D, Hochberg U, Lidar Z, Regev GJ. Minimally invasive discectomy versus open laminectomy and discectomy for the treatment of cauda equina syndrome: A preliminary study and case series. Front Surg. 2022 Oct 12;9:1031919. doi: 10.3389/fsurg.2022.1031919. PMID: 36311945; PMCID: PMC9597079.
  22. Rahyussalim AJ, Zufar MLL, Kurniawati T. Significance of the Association between Disc Degeneration Changes on Imaging and Low Back Pain: A Reⅵew Article. Asian Spine J. 2020;14:245-57. doi: 10.31616/asj.2019.0046.. PMID: 31679325; PMCID: PMC7113468.
  23. 23- Suthar P, Patel R, Mehta C, Patel N. MRI evaluation of lumbar disc degenerative disease. J Clin Diagn Res. 2015;9:TC04-9. doi: 10.7860/JCDR/2015/11927.5761. Epub 2015 Apr 1. PMID: 26023617; PMCID: PMC4437133.
  24. Luo D, Ji C, Xu H, Feng H, Zhang H, Li K. Intradural disc herniation at L4/5 level causing Cauda equina syndrome: A case report. Medicine (Baltimore). 2020;99:e19025. doi: 10.1097/MD.0000000000019025. PMID: 32049799; PMCID: PMC7035013.
  25. Diⅵ SN, Makanji HS, Kepler CK, Anderson DG, Goyal DKC, Warner ED, Galetta MS, Hilibrand AS, Kaye ID, Kurd MF, Radcliff KE, Rihn JA, Woods BI, Vaccaro AR, Schroeder GD. Does the Size or Location of Lumbar Disc Herniation Predict the Need for Operative Treatment? Global Spine J. 2022 ;12:237-43. doi: 10.1177/2192568220948519. Epub 2020 Sep 16. PMID: 32935569; PMCID: PMC8907636.
  26. Traⅵs Caton M Jr, Wiggins WF, Pomerantz SR, Andriole KP. Effects of age and sex on the distribution and symmetry of lumbar spinal and neural foraminal stenosis: a natural language processing analysis of 43,255 lumbar MRI reports. Neuroradiology. 2021;63:959-66. doi: 10.1007/s00234-021-02670-6. Epub 2021 Feb 16. PMID: 33594502; PMCID: PMC8128837.
  27. Abdalkader M, Guermazi A, Engebretsen L, Roemer FW, Jarraya M, Hayashi D, Crema MD, Mian AZ. MRI-detected spinal disc degenerative changes in athletes participating in the Rio de Janeiro 2016 Summer Olympics games. BMC Musculoskelet Disord. 2020 ;21:45. doi: 10.1186/s12891-020-3057-3. PMID: 31959161; PMCID: PMC6972034.
  28. Parenteau CS, Lau EC, Campbell IC, Courtney A. Prevalence of spine degeneration diagnosis by type, age, gender, and obesity using Medicare data. Sci Rep. 2021;11:5389. doi: 10.1038/s41598-021-84724-6. PMID: 33686128; PMCID: PMC7940625..
  29. Munir, S., Rade, M., Määttä, J.H. et al.Intervertebral Disc Biology: Genetic Basis of Disc Degeneration. Curr Mol Bio Rep 4, 143–150.
  30. 30-Akeda K, Yamada T, Inoue N, Nishimura A, Sudo A. Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly. BMC Musculoskelet Disord. 2015 ;16:344. doi: 10.1186/s12891-015-0798-5. PMID: 26552449; PMCID: PMC4640385.
  31. Shimizu, M., Kobayashi, T., Chiba, H. et al. Adult spinal deformity and its relationship with height loss: a-year longitudinal cohort study. BMC Musculoskelet Disord 2020;21:422. https://doi.org/10.1186/s12891-020-03464-2
  32. Fjeld OR, Grøvle L, Helgeland J, Småstuen MC, Solberg TK, Zwart JA, Grotle M. Complications, reoperations, readmissions, and length of hospital stay in 34 639 surgical cases of lumbar disc herniation. Bone Joint J. 2019;101-B:470-77.
  33. 33-Malkoç I, Aydinlioglu SA, Alper F, Kaciroglu F, Yuksel Y, Yuksel R, Dane S, Toktas M. Age related changes in height and shape of the lumbar intervertebral discus. Europoean Journal of Basic Medical Sciences 2012;2:68–73.
  34. Urquhart DM, Kurniadi I, Triangto K, Wang Y, Wluka AE, O’Sullivan R, Jones G, Cicuttini FM. Obesity is associated with reduced disc height in the lumbar spine but not at the lumbosacral junction. Spine (Phila Pa 1976) 2014;39:E962–6. 25
  35. Mosley GE, Wang M, Nasser P, Lai A, Charen DA, Zhang B, Iatridis JC. Males and females exhibit distinct relationships between intervertebral disc degeneration and pain in a rat model. Sci Rep. 2020;10:15120. doi: 10.1038/s41598-020-72081-9. PMID: 32934258; PMCID: PMC7492468.
  36. Wáng YX, Wáng JQ, Káplár Z. Increased low back pain prevalence in females than in males after menopause age: eⅵdences based on synthetic literature reⅵ Quant Imaging Med Surg. 2016;6:199-206. doi: 10.21037/qims.2016.04.06. PMID: 27190772; PMCID: PMC4858456.
  37. 37-Kawaguchi Y. Genetic background of degenerative disc disease in the lumbar spine. Spine Surg Relat Res. 2018 ;2:98-112. doi: 10.22603/ssrr.2017-0007. PMID: 31440655; PMCID: PMC6698496.
  38. Yoshiiwa T, Miyazaki M, Notani N, Ishihara T, Kawano M, tsumura H. Analysis of the Relationship between Ligamentum flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis. Asian Spine J. 2016;10:1132-40. doi: 10.4184/asj.2016.10.6.1132. Epub 2016 Dec 8. PMID: 27994791; PMCID: PMC5165005.
  39. Mihara A, Nishida N, Jiang F, Ohgi J, Imajo Y, Suzuki H, Funaba M, Yamagata H, Chen X, Sakai T. Tensile Test of Human Lumbar Ligamentum flavum: Age-Related Changes of Stiffness. Applied Sciences. 2021;11:33-37. https://doi.org/10.3390/app11083337
  40. Chuang, H.C.; tsai, K.L.; tsai, K.J.; Tu, T.Y.; Shyong, Y.J.; Jou, I.M.; Hsu, C.C.; Shih, S.S.; Liu, Y.F.; Lin, C.L. Oxidative stress mediates age-related hypertrophy of ligamentum flavum by inducing inflammation, fibrosis, and apoptosis through activating Akt and MAPK pathways. Aging 2020;12:24168–83.
  41. 41- Khasawneh R, Abu El-Rub E, Allouh M. Human lumbosacral root and ligamentum flavum thicknesses: a magnetic resonance study. Folia Morphol (Warsz). 2021 Nov 16. doi: 10.5603/FM.a2021.0120. Epub ahead of print. PMID: 34783005.
  42. Sun, C.; Zhang, H.; Wang, X.; Liu, X. Ligamentum flavum fibrosis and hypertrophy: Molecular pathways, cellular mechanisms, and future directions. FASEB J. 2020;34: 9854–68.
  43. Mihara, Atsushi & Nishida, Norihiro & Jiang, Fei & Ohgi, Junji & Imajo, Yasuaki & Suzuki, Hidenori & Funaba, Masahiro & Yamagata, Hiroki & Chen, Xian & Sakai, TakashiTensile Test of Human Lumbar Ligamentum Flavum: Age-Related Changes of Stiffness. Appl. Sci. 2021;11:33-37. https://doi.org/10.3390/app11083337
  44. van der Heijde D, Braun J, Deodhar A, Baraliakos X, Landewé R, Richards HB, Porter B, Readie A. Modified stoke ankylosing spondylitis spinal score as an outcome measure to assess the impact of treatment on structural progression in ankylosing spondylitis. Rheumatology (Oxford). 2019 ;58:388-400. doi: 10.1093/rheumatology/key128. PMID: 29860356; PMCID: PMC6381766.
  45. Winegar BA, Kay MD, Taljanovic M. Magnetic resonance imaging of the spine. Pol J Radiol. 2020;85:e550-74. doi: 10.5114/pjr.2020.99887. PMID: 33101557; PMCID: PMC7571515.
  46. Yabuki S, Fukumori N, Takegami M, Onishi Y, Otani K, Sekiguchi M, Wakita T, Kikuchi S, Fukuhara S, Konno S. Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: a population-based study. J Orthop Sci. 2013 Nov;18(6):893-900. doi: 10.1007/s00776-013-0455-5. Epub 2013 Aug 21. Erratum in: J Orthop Sci. 2013;18:901. PMID: 23963588; PMCID: PMC3838585.
  47. Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016 Jan 4;352:h6234. doi: 10.1136/bmj.h6234. PMID: 26727925; PMCID: PMC6887476.
  48. Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Aⅵns AL, James K, Wald JT, Kallmes DF, Jarⅵk JG. Systematic literature reⅵew of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36:811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. PMID: 25430861; PMCID: PMC4464797
  49. Ogon I, Takashima H, Morita T, Oshigiri T, Terashima Y, Yoshimoto M, Fukushi R, Fujimoto S, Emori M, Teramoto A, Takebayashi T, Yamashita T. Relevance between Schmorl's Node and Lumbar Intervertebral Disc Degeneration Quantified with Magnetic Resonance Imaging T2 Mapping in Chronic Low Back Pain. Asian Spine J. 2020;14:621-28. doi: 10.31616/asj.2019.0231. Epub 2020 Mar 30. PMID: 32213795; PMCID: PMC7595827.
  50. Abbas J, Hamoud K, Peled N, Hershkovitz I. Lumbar Schmorl's Nodes and Their Correlation with Spine Configuration and Degeneration. Biomed Res Int. 2018 ;2018:1574020. doi: 10.1155/2018/1574020. PMID: 30533426; PMCID: PMC6247654.
 

Statistics
Article View: 67
PDF Download: 44


Journal Management System. Powered by ejournalplus.com