Detection of Lumbar Spine Degenerative Alterations in Low Back Pain Patients with Varying Ages – A Comprehensive Study
DOI:
https://doi.org/10.3889/oamjms.2022.10997Keywords:
Disc degeneration, Desiccation, Bulging, Low back pain, Lumbar spineAbstract
Objective: Low back pain in the lumbar spine causes a serious impact in the health care systems. This study was undertaken to detect disc degenerative alterations in different age group patients suffering from low-back pain.
Methods: This study was conducted on 199 patients (153 males and 46 females) suffering with low-back pain. Lumbar spine magnetic resonance imaging (MRI) 1.5T was applied and the patients with varying ages were studied on the basis of detection of degenerative alterations in the lumbar segments and the findings were compared in both genders.
Results: The MRI based detection showed that 55.3% patients were affected with single desiccation (DS), 46.7% patients with disc bulging, 42.2% patients with desiccation with bulging (DB), 44.7% patients were affected with desiccation at multiple levels (DML) and 40.7% patients were desiccation and bulging at multiple levels (DBML). Interestingly, the detection of disc degeneration was almost the same in both genders (p>0.05). The DS and disc bulging at single level were more prevalent in both genders with age<40 years. Interestingly, the DML and DBML were more prevalent in patients 40-60 years old in both genders. Importantly, the DML was found to be statistically higher in both genders with age≥40 years as compared with patients with age<years (p<0.05). The DBML level was also higher in both genders with age≥40 years but it was statistically insignificant (p>0.05).
Conclusions: This study determined that the disc degenerative alterations in the lower lumbar spine appear at all age levels. Interestingly, there was no difference in the prevalence of disc degenerative alterations in both genders. The data also concluded that age advances the progressive occurrence of degenerative alterations at multiple levels in the lower lumbar spine.
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Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, et al. Low back pain, a comprehensive review: Pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep. 2019;23(3):23. https://doi.org/10.1007/s11916-019-0757-1 PMid:30854609
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67. https://doi.org/10.1016/S0140-6736(18)30480-X PMid:29573870
Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-47. https://doi.org/10.1016/S0140-6736(16)30970-9 PMid:27745712
Wettstein M, Eich W, Bieber C, Tesarz J. Pain intensity, disability, and quality of life in patients with chronic low back pain: Does age matter? Pain Med. 2019;20(3):464-75. https://doi.org/10.1093/pm/pny062 PMid:29701812
Knezevic NN, Candido KD, Vlaeyen JW, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021;398(10294):78-92. https://doi.org/10.1016/S0140-6736(21)00733-9 PMid:34115979
Gopalakrishnan N, Nadhamuni K, Karthikeyan T. Categorization of pathology causing low back pain using magnetic resonance imaging (MRI). J Clin Diagn Res. 2015;9(1):TC17-20. https://doi.org/10.7860/JCDR/2015/10951.5470 PMid:25738056
Kasch R, Truthmann J, Hancock MJ, Maher CG, Otto M, Nell C, et al. Association of lumbar MRI findings with current and future back pain in a population-based cohort study. Spine (Phila Pa 1976). 2022;47(3):201-11. https://doi.org/10.1097/BRS.0000000000004198 PMid:3440582
Suthar P, Patel R, Mehta C, Patel N. MRI evaluation of lumbar disc degenerative disease. J Clin Diagn Res. 2015;9(4):TC04-9. https://doi.org/10.7860/JCDR/2015/11927.5761 PMid:26023617
Dutta S, Bhave A, Patil S. Correlation of 1.5 tesla magnetic resonance imaging with clinical and intraoperative findings for lumbar disc herniation. Asian Spine J. 2016;10(6):1115-21. https://doi.org/10.4184/asj.2016.10.6.1115 PMid:27994789
Kim KY, Wang MY. Magnetic resonance image-based morphological predictors of single photon emission computed tomography-positive facet arthropathy in patients with axial back pain. Neurosurgery. 2006;59(1):147-56;discussion 147-56. https://doi.org/10.1227/01.NEU.0000219956.58725.6F PMid:16823311
Lukecha KR, Geoffrey E, Gonzaga MA, Sam B. Magnetic resonance imaging findings among young adults with low back pain at Nsambya hospital. BMC Med Imaging. 2022;22(1):108. https://doi.org/10.1186/s12880-022-00830-5 PMid:35659200
Alqossayir FM, Alkhowailed MS, Alammar AY, Alsaeed AA, Alamri YY, Rasheed Z. Factors associated with patients bypassing primary healthcare centres in qassim region, KSA. J Taibah Univ Med Sci. 2021;16(6):900-5. https://doi.org/10.1016/j.jtumed.2021.07.012 PMid:34899136
Rasheed Z, Al-Rashidy M, Al-Raqibah A, Al-Moqbel A, Al-Bakri A, Al-Harbi A, et al. Experience of cancer patients for the usage of complementary and alternative medicine therapy. Open Access Maced J Med Sci. 2020;8(E):521-7. https://doi.org/10.3889/oamjms.2020.5012
Taher F, Essig D, Lebl DR, Hughes AP, Sama AA, Cammisa FP, et al. Lumbar degenerative disc disease: Current and future concepts of diagnosis and management. Adv Orthop. 2012;2012:970752. https://doi.org/10.1155/2012/970752 PMid:22567411
Romaniyanto, Mahyudin F, Prakoeswa CR, Notobroto HB, Tinduh D, Ausrin R, et al. An update of current therapeutic approach for intervertebral disc degeneration: A review article. Ann Med Surg (Lond). 2022;77:103619. https://doi.org10.1016/j.amsu.2022.103619 PMid:35638079
Fernandez-Moure J, Moore CA, Kim K, Karim A, Smith K, Barbosa Z, et al. Novel therapeutic strategies for degenerative disc disease: Review of cell biology and intervertebral disc cell therapy. SAGE Open Med. 2018;6:2050312118761674. https://doi.org/10.1177/2050312118761674 PMid:29568524
Khanduja S, Loomba V, Salama-Hannah J, Upadhyay A, Khanduja N, Chauhan G. Retrospective review of magnetic resonance imaging of the lumbosacral spine: Are we overinvestigating? Neurospine. 2018;15(4):383-7. https://doi.org/10.14245/ns.1836110.055 PMid:30531654
Akuthota V, Meron AJ, Singh JR, Boimbo S, Laker SR, Holman RB, et al. The utility of magnetic resonance imaging results in physician decision-making before initial lumbar spinal injection. Spine J. 2019;19(9):1455-62. https://doi.org/10.1016/j.spinee.2019.04.016 PMid:31009770
Jain M, Vijaywargiya M. Degenerative changes in lumbar spine on MRI: A retrospective study. Int J Med Res Rev. 2016;4(6):1030-4. https://doi.org/10.17511/ijmrr.2016.i06.28
Ekin EE, Altunrende ME. Chronic low back pain in young population: An MRI study. Middle East J Rehabil Health Stud. 2018;5(2):e64143. https://doi.org/10.5812/mejrh.64143
Sether LA, Yu S, Haughton VM, Fischer ME. Intervertebral disk: Normal age-related changes in MR signal intensity. Radiology. 1990;177(2):385-8. https://doi.org/10.1148/radiology.177.2.2217773 PMid:2217773
Lundon K, Bolton K. Structure and function of the lumbar intervertebral disk in health, aging, and pathologic conditions. J Orthop Sports Phys Ther. 2001;31(6):291-303;discussion 304-6. https://doi.org/10.2519/jospt.2001.31.6.291 PMid:11411624
Demontiero O, Vidal C, Duque G. Aging and bone loss: New insights for the clinician. Ther Adv Musculoskelet Dis. 2012;4(2):61-76. https://doi.org/10.1177/1759720X11430858 PMid:22870496
Wáng YX. Continued progression of lumbar disc degeneration in postmenopausal women. Climacteric. 2015;18(3):435. https://doi.org/10.3109/13697137.2014.999662 PMid:25728704
Paul CP, Smit TH, de Graaf M, Holewijn RM, Bisschop A, van de Ven PM, et al. Quantitative MRI in early intervertebral disc degeneration: T1rho correlates better than T2 and ADC with biomechanics, histology and matrix content. PLoS One. 2018;13(1):e0191442. https://doi.org/10.1371/journal.pone.0191442 PMid:29381716
Schoenfeld AJ, Nelson JH, Burks R, Belmont PJ Jr. Incidence and risk factors for lumbar degenerative disc disease in the United States military 1999-2008. Mil Med. 2011;176(11):1320-4. https://doi.org10.7205/milmed-d-11-00061 PMid:22165663
Battié MC, Videman T. Lumbar disc degeneration: Epidemiology and genetics. J Bone Joint Surg Am. 2006;88 Suppl 2:3-9. https://doi.org/10.2106/JBJS.E.01313 PMid:16595435
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