Cervical Disc Protrusion Correlates With the Severity of Cervical Disc Degeneration
Cervical Disc Protrusion Correlates With the Severity of Cervical Disc Degeneration
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DOI：
10.1097/brs.0000000000000953
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发表时间：
2015-07-01
期刊：
影响因子：
3
通讯作者：
Kato, Fumihiko
中科院分区：
文献类型：
--
作者：
Nakashima, Hiroaki;Yukawa, Yasutsugu;Kato, Fumihiko
研究设计.横截面研究。本研究的目的是（1）调查颈椎磁共振（MR）图像上颈椎间盘退变和突出的频率和程度;（2）分析椎间盘退变严重程度与椎间盘突出之间的相关性。在健康受试者的MR图像上，经常观察到颈椎间盘退行性改变或突出。然而，很少有大规模的研究，这些发现在健康受试者中的频率和范围尚未明确。此外，关于颈椎间盘退变与椎间盘突出之间的相关性尚未见报道。对1211名相对健康的志愿者采用磁共振成像技术前瞻性测量颈椎间盘退变和突出。其中包括20岁至70岁之间每十年至少100名男性和100名女性。根据改良Pfirrmann分级系统定义颈椎间盘退变，并根据矢状面MRI上椎间盘突出前后径评估椎间盘突出量。轻度椎间盘退变非常常见，包括98.0%的20多岁男性和女性。随着年龄的增长，男女各节段颈椎间盘退变的严重程度均显著增加。椎间盘退变主要发生在C5-C6和C6-C7。除50多岁的个体外，性别之间的差异不显著。腰椎间盘突出前后径随年龄增长而增大，20 ~ 40岁组增加最明显。椎间盘突出前后径随椎间盘退变程度的加重而增大。即使在20多岁的健康受试者中也经常观察到颈椎间盘退变和突出，并随着年龄的增长而恶化。颈椎间盘突出与颈椎间盘退变显著相关，MR图像上观察到的生化退行性改变影响颈椎间盘空间突出。证据等级：2
Study Design. Cross-sectional study.Objective. The purposes of this study were (1) to investigate the frequency and degree of cervical disc degeneration and protrusion on cervical spine magnetic resonance (MR) images and (2) to analyze the correlation between the severity of disc degeneration and disc protrusion.Summary of Background Data. Cervical disc degenerative changes or protrusion is commonly observed on MR images in healthy subjects. However, there are few large-scale studies, and the frequency and range of these findings in healthy subjects have not been clarified. Moreover, there are no reports regarding the correlation between cervical disc degeneration and disc protrusion.Methods. Cervical disc degeneration and protrusion were prospectively measured using magnetic resonance imaging in 1211 relatively healthy volunteers. These included at least 100 males and 100 females in each decade of life between the 20s and the 70s. Cervical disc degeneration was defined according to the modified Pfirrmann classification system, and the amount of disc protrusion was evaluated using the anteroposterior diameter of disc protrusion on sagittal MR image.Results. Mild disc degeneration was very common, including 98.0% of both sexes in their 20s. The severity of cervical disc degeneration significantly increased with age in both sexes at every level. The disc degeneration predominantly occurred at C5-C6 and C6-C7. The difference between sexes was not significant except for individuals in their 50s. The average anteroposterior diameter of disc protrusion increased with aging, especially from the 20s to the 40s. The anteroposterior diameter of disc protrusion increased with a progression in the disc degeneration grade.Conclusion. Cervical disc degeneration and protrusion were frequently observed in healthy subjects even in their 20s and deteriorated with age. Cervical disc protrusion was significantly correlated with cervical disc degeneration, and spatial cervical disc protrusion was affected by biochemical degenerative changes as observed on MR images. Level of Evidence: 2