Whole Spine Disc Degeneration Survey according to the Ages and Sex Using Pfirrmann Disc Degeneration Grades

다국어 초록 (Multilingual Abstract)

Objective: Pfirrmann disc grade is a useful scoring tool for evaluating disc degeneration, but normal values according to aging process has not been elucidated. This study was conducted to identify the prevalence and pattern of whole spine disc degeneration according to ages and gender differences. Methods: Total 653 patients (336 male and 317 female patients, 48.1±58.7 years old) who took whole spine magnetic resonance images were enrolled in this study. There were 19 cases in their 2nd decades and 74 cases in 3rd decades, 141 cases in 4th decades, 129 cases in 5th decades, 139 cases in 6th decades, and 93 cases in 7th decades, 58 cases in over 8th decades. Pfirrmann disc grades were measured according to sex and ages by 2 neurosurgeons that were blind to this study. Results: All spinal disc degeneration grades were correlated with ageing. The Pfirrmann disc grades of degeneration in all spine levels showed the statistically significant difference according to the ages (p<0.001). The common Pfirrmann disc grades according to the ages were grade 3 among 2nd to 5th decades, and grade 4 was more common than 6th decades. The lower cervical level (C2-3 to C4-5) and lumbar level (L1-2 to L5-S1) were happened relatively early severe disc degeneration compared to other levels. The intersexual differences were increased after 6th decades. Conclusion: Disc degeneration is natural course after one’s 2nd decades. And its incidence and grade were increased with age, and more affected by sexual difference after 6th decades.

참고문헌 (Reference)

1 Roughley PJ, "The structure and degradation of aggrecan in human intervertebral disc" 15 (15): S326-S332, 2006

2 Hadjipavlou AG, "The pathophysiology of disc degeneration: a critical review" 90 : 1261-1270, 2008

3 Lee MJ, "The natural history of degeneration of the lumbar and cervical spines:a systematic review" 37 (37): S18-S30, 2012

4 Chung SA, "The molecular basis of intervertebral disk degeneration" 34 : 209-219, 2003

5 Colombier P, "The lumbar intervertebral disc: from embryonic development to degeneration" 81 : 125-129, 2014

6 Ohshima H, "The effect of lactate and pH on proteoglycan and protein synthesis rates in the intervertebral disc" 17 : 1079-1082, 1992

7 Erwin WM, "The Notochord, Notochordal cell and CTGF/CCN-2:ongoing activity from development through maturation" 2 : 59-65, 2008

8 Dae Cheol Rim, "Quantitative Pfirrmann Disc Degeneration Grading System to Overcome the Limitation of Pfirrmann Disc Degeneration Grade" 대한척추신경외과학회 13 (13): 1-8, 2016

9 김상진, "Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 3 : Cervical and Lumbar Relationship" 대한신경외과학회 53 (53): 167-173, 2013

10 이태훈, "Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 2 : Cervical Spine" 대한신경외과학회 53 (53): 89-95, 2013

11 김상진, "Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 1 : Lumbar Spine" 대한신경외과학회 53 (53): 31-38, 2013

12 Takeno K, "Physical limitations to tissue engineering of intervertebral disc cells: effect of extracellular osmotic change on glycosaminoglycan production and cell metabolism. Laboratory investigation" 7 : 637-644, 2007

13 Erwin WM, "Nucleus pulposus notochord cells secrete connective tissue growth factor and up-regulate proteoglycan expression by intervertebral disc chondrocytes" 54 : 3859-3867, 2006

14 Erwin WM, "Notochordal cells protect nucleus pulposus cells from degradation and apoptosis: implications for the mechanisms of intervertebral disc degeneration" 13 : R215-, 2011

15 Aguiar DJ, "Notochordal cells interact with nucleus pulposus cells: regulation of proteoglycan synthesis" 246 : 129-137, 1999

16 Williams FM, "Neck and back pain and intervertebral disc degeneration: role of occupational factors" 25 : 69-79, 2011

17 Pfirrmann CW, "Magnetic resonance classification of lumbar intervertebral disc degeneration" 26 : 1873-1878, 2001

18 Luoma K, "Low back pain in relation to lumbar disc degeneration" 25 : 487-492, 2000

19 Grunhagen T, "Intervertebral disk nutrition: a review of factors influencing concentrations of nutrients and metabolites" 42 : 465-477, 2011

20 Cats-Baril WL, "Identifying patients at risk of becoming disabled because of low-back pain. The Vermont Rehabilitation Engineering Center predictive model" 16 : 605-607, 1991

21 Kao PY, "Genetics of lumbar disk degeneration: technology, study designs, and risk factors" 42 : 479-486, 2011

22 Haeusler M, "Evidence for juvenile disc herniation in a homo erectus boy skeleton" 38 : E123-E128, 2013

23 Okada E, "Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation:comparison study with asymptomatic volunteers" 20 : 585-591, 2011

24 Boos N, "Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science" 27 : 2631-2644, 2002

25 Akyol S, "Catabolic cytokine expressions in patients with degenerative disc disease" 20 : 492-499, 2010

26 Roughley PJ, "Biology of intervertebral disc aging and degeneration:involvement of the extracellular matrix" 29 : 2691-2699, 2004

27 Gawri R, "Best paper NASS 2013: link-N can stimulate proteoglycan synthesis in the degenerated human intervertebral discs" 26 : 107-119, 2013

28 Takatalo J, "Association of abdominal obesity with lumbar disc degeneration--a magnetic resonance imaging study" 8 : e56244-, 2013

29 Frith JE, "An injectable hydrogel incorporating mesenchymal precursor cells and pentosan polysulphate for intervertebral disc regeneration" 34 : 9430-9440, 2013