Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations

被引：703

作者：

Brinjikji, W. ^{[1
]}

Luetmer, P. H. ^{[1
]}

Comstock, B. ^{[2
,3
]}

Bresnahan, B. W. ^{[3
]}

Chen, L. E. ^{[3
]}

Deyo, R. A. ^{[6
,7
,8
,9
]}

Halabi, S. ^{[10
]}

Turner, J. A. ^{[4
]}

Avins, A. L. ^{[11
,12
]}

James, K. ^{[3
]}

Wald, J. T. ^{[1
]}

Kallmes, D. F. ^{[1
]}

Jarvik, J. G. ^{[3
,5
]}

机构：

[1] Mayo Clin, Dept Radiol, Rochester, MN 55905 USA

[2] Univ Washington, Dept Biostat, Comparat Effectiveness Cost & Outcomes Res Ctr, Seattle, WA 98195 USA

[3] Univ Washington, Dept Radiol, Comparat Effectiveness Cost & Outcomes Res Ctr, Seattle, WA 98195 USA

[4] Univ Washington, Dept Psychiat & Behav Sci, Comparat Effectiveness Cost & Outcomes Res Ctr, Seattle, WA 98195 USA

[5] Univ Washington, Dept Neurol Surg & Hlth Serv, Comparat Effectiveness Cost & Outcomes Res Ctr, Seattle, WA 98195 USA

[6] Oregon Hlth & Sci Univ, Dept Family Med, Portland, OR 97201 USA

[7] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA

[8] Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA

[9] Oregon Hlth & Sci Univ, Oregon Inst Occupat Hlth Sci, Portland, OR 97201 USA

[10] Henry Ford Hosp, Dept Radiol, Detroit, MI 48202 USA

[11] Univ Calif San Francisco, Dept Radiol, San Francisco, CA USA

[12] Kaiser Permanente No Calif, Div Res, Oakland, CA USA

来源：

AMERICAN JOURNAL OF NEURORADIOLOGY | 2015年 / 36卷 / 04期

基金：

美国国家卫生研究院;

关键词：

LOW-BACK-PAIN; INTERVERTEBRAL DISC DEGENERATION; MAGNETIC-RESONANCE; LUMBAR SPINE; MR-IMAGES; FACET JOINTS; PREVALENCE; INDIVIDUALS; HERNIATION; ABNORMALITIES;

D O I：

10.3174/ajnr.A4173

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

This meta-analysis of the literature reveals that imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. BACKGROUND AND PURPOSE: Degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. We sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals. MATERIALS AND METHODS: We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014. Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates. For each imaging finding, we fit a generalized linear mixed-effects model for the age-specific prevalence estimate clustering in the study, adjusting for the midpoint of the reported age interval. RESULTS: Thirty-three articles reporting imaging findings for 3110 asymptomatic individuals met our study inclusion criteria. The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age. CONCLUSIONS: Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient's clinical condition.

引用

页码：811 / 816

页数：6

共 52 条

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