Objective:To determine the most common patterns in symptomatic lumbar intervertibral disc degeneration at various age period.Method:The lumbar MRI imaging data of 529 patients treated for low back pain with or without skelagia in Santa Monica hospital in USA from 2004 to 2006 were reviewed retrospectively in this study .There were 191 females, 338 males.Degenerative grading was made for all disc levels in the lumbar spine for each patient. The patients were also classified into five age different groups starting from below age 30,with the intervals of a single decade,until over age 60 (≤29 years,30-39 years,40-49 years, 50-59 years and≥60 years).The degenerative grade of all disc levels (L1/2 to L5/S1) in each patient was classified based on Pfirrmann's gading system,and locations and the progressive manner of the degeneration were determined for age groups.SPSS software version 13.0 (SPSS Inc.,Chicago,IL) on a personal computer was used for statistical analyses.Result:The most common pattern in all ages is normal in all the discs and it is described as 1-1-1-1-1 and this normal pattern was found in 71 patients (13.4%).There was rare change to develop severe degeneration (grade 4) for low age groups.The upper levels of the lumbar spine had more commonly lower degenerative grades,and the lower levels had relatively higher grades of advanced disc de-generation.In the age groups of below 29 years and 30-39 years,the most common pattern was normal in all the discs of 5 levels as 1-1-1-1-1.And this pattern was more prominent in the age group below 29 years.In the age group of 40-49 years.it was changed to single level L5-S1 degeneration with 1-1-1-1-3(7.6%) butthe normal discs in all levels had also a similar portion(6.8%).In the age groups of 50-59 years and over 60 years,it was changed to the pattern with all discs abnormal as 3-3-3-3-3.Single level involvement was negatively correlated with age (P<0.01 ).On the contrary,whole symmetrical degenerative involvement of all levels was positively correlated with age (P<0.01).Single L5/S1 involvement was most common in the age group of below 29 years,but in the age group of 30-39 years,the most common pattern was changed to L4/5 and L5/ S1 double involvement(P< 0.05).A relative small portion appeared as the most common pattern with less than two-level involvement in the age groups over 50 years.Conclusion:The rate of unilevel degenerative pattern of lumbar spine in overall population decreases with the progression of age, while that of all-level degenerative pattern increases with the progression of age.

OBJECTIVE: To investigate the effectiveness of radiographic parameters on segmental instability in the lumbar spine using Kinetic magnetic resonance imaging (MRI). METHODS: Segmental motion, defined as excessive (more than 3 mm) translational motion from flexion to extension, was investigated in 309 subjects (927 segments) using Kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration (DD), facet joint osteoarthritis (FJO), and ligament flavum hypertrophy (LFH). These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. RESULTS: The overall incidence of segmental instability was 10.5% at L3-L4, 16.5% at L4-L5, and 7.3% at L5-S1. DD and LFH at L3-L4 and FJO and LFH at L4-L5 were individually associated with segmental instability (p<0.05). At L4-L5, the following combinations had a higher incidence of segmental instability (p<0.05) when compared to other segments : (1) Grade IV DD with grade 3 FJO, (2) Grade 2 or 3 FJO with the presence of LFH, and (3) Grade IV DD with the presence of LFH. At L5-S1, the group with Grade III disc and Grade 3 FJO had a higher incidence of segmental instability than the group with Grade I or II DD and Grade 1 FJO. CONCLUSION: This study showed that the presences of either Grade IV DD or grade 3 FJO with LFH at L4-L5 were good indicators for segmental instability. Therefore, using these parameters simultaneously in patients with segmental instability would be useful for determining candidacy for surgical treatment.
Humans ; Hypertrophy ; Incidence ; Intervertebral Disc Degeneration ; Ligaments ; Magnetic Resonance Imaging ; Osteoarthritis ; Spine ; Zygapophyseal Joint