Researchers from Hebrew SeniorLife's Institute for Ageing Research, and Boston Medical Centre have reported that one-third of people 40-59 years have image-based evidence of moderate to severe degenerative disc disease and more than half had moderate to severe spinal osteoarthritis. Beyond that, the prevalence of disc height narrowing and joint osteoarthritis increased 2- to 4-fold in those aged 60-69 and 70-89 respectively. Furthermore, scientists observed that progression of these conditions occurred 40%-70% more frequently in women than men.
To uncover these results, scientists used CT scans taken six years apart to evaluate the severity of disc disease and spinal osteoarthritis in 1200 cohort members of the Framingham Study – a collection of data from Framingham, Massachusetts residents and their offspring dating back to the 1940s.
Dr Elizabeth Samelson, associate scientist at the Institute for Ageing Research and author of this study said: "Spinal degenerative conditions, including disc height narrowing and joint osteoarthritis are common causes of pain, reduced function, and health care costs in older adults. Despite the clinical importance, little is known about the frequency and progression of spinal degenerative disease in the general population. Therefore, we conducted a study to describe the prevalence and progression in a population-based cohort."
Abstract
Background Context: Prevalence and progression of disc height narrowing (DHN) and facet joint osteoarthritis (FJOA) in the thoracic and lumbar regions in non-clinical populations are not well established.
Purpose: The present study aimed to use computed tomography (CT) images to determine the prevalence and progression of DHN and FJOA according to age, sex, and spinal region.
Study Design: This is a 6-year longitudinal study.
Sample: A total of 1,195 members of the Framingham Study (mean baseline age 61±9 years) were included in the study.
Outcome Measures: We compared the prevalence and progression (new or worsening) of moderate-to-severe DHN and FJOA by age, sex, and spinal region.
Methods: A musculoskeletal radiologist evaluated DHN and FJOA from T4/T5 to L4/L5 on baseline and follow-up CT images using a semi-quantitative scale: 0=normal, 1=mild, 2=moderate, and 3=severe.
Results: One-third or more of women and men ages 40–59 years at baseline had imaged-based evidence of prevalent DHN, more than half had prevalent FJOA, and DHN and FJOA prevalence increased approximately two- to fourfold in those age 60–69 and 70–89 years at baseline, respectively (p<.01). Progression of DHN and FJOA occurred more frequently at the lumbar than at the thoracic spine and more in women than in men (DHN: odds ratio [OR]=1.42, 95% confidence interval [CI]=1.07, 1.88; FJOA: OR=1.70, CI=1.33, 2.17).
Conclusions: Prevalence and progression of moderate-to-severe DHN and FJOA are common in non-clinical populations of older adults. The high frequency of spinal degeneration observed on CTs in this community-based study may contribute to challenges in interpreting the clinical significance of imaging evidence of DHN and FJOA. Future studies investigating the association of CT-based spinal degenerative features with pain and functional impairments in population-based samples are needed to help determine the clinical significance of imaged-based findings of DHN and FJOA.
Authors
Mohamed Jarraya, Ali Guermazi, Amanda L Lorbergs, Elana Brochin, Douglas P Kiel, Mary L Bouxsein, L Adrienne Cupples, Elizabeth J Samelson
[link url="http://www.hebrewseniorlife.org/body.cfm?id=2194&action=detail&ref=71"]Hebrew SeniorLife Institute of Aging Research material[/link]
[link url="https://www.thespinejournalonline.com/article/S1529-9430(18)30164-5/fulltext"]The Spine Journal abstract[/link]