Does Lumbar Disc Degeneration on Magnetic Resonance Imaging Associate With Low Back Symptom Severity in Young Finnish Adults?
Does Lumbar Disc Degeneration on Magnetic Resonance Imaging Associate With Low Back Symptom Severity in Young Finnish Adults?
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DOI：
10.1097/brs.0b013e3182077122
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发表时间：
2011-12-01
期刊：
影响因子：
3
通讯作者：
Tervonen, Osmo
中科院分区：
文献类型：
--
作者：
Takatalo, Jani;Karppinen, Jaro;Tervonen, Osmo
研究设计。对腰痛（LBP）和功能限制进行横断面磁共振成像研究。研究芬兰年轻成年人腰椎间盘退变（DD）与腰背部症状严重程度之间的关系。背景资料摘要。腰痛和腰椎DD在青春期已经很常见了，但是很少有人知道它们在年轻人中的关联。来自出生队列的年轻人（n = 874）被邀请使用1.5 t扫描仪进行腰椎磁共振成像。在18岁、19岁和21岁时，腰痛和功能限制的数据被用来使用潜在分类分析对腰背部症状的受试者进行聚类。比较两组患者21岁时DD的患病率和95%置信区间以及各腰椎水平DD的总评分。采用logistic回归分析DD及其他影像学表现（疝、环撕裂、modc改变、峡部裂缺陷）对症状严重程度的影响。潜在类分析从554名受试者中产生了5个簇，从在所有时间点都有疼痛的受试者（n = 65）到无症状的聚类（n = 168）。DD在三个症状最多的组中比在两个症状最少的组中更普遍。同样的结果也适用于DD和评分。腰椎DD与症状严重程度无关，与其他退行性表现无关。此外，中度椎间盘退变比轻度椎间盘退变更可能与最严重的腰背部症状相关。在年轻人中，椎间性DD与腰背部症状的严重程度相关，提示该年龄段的症状可能有椎间盘源性起源。然而，在三分之一的无症状受试者中也发现了DD。
Study Design. A cross-sectional magnetic resonance imaging study with questionnaires on low back pain (LBP) and functional limitations.Objective. To investigate the association between lumbar intervertebral disc degeneration (DD) and low back symptom severity among young Finnish adults.Summary of Background Data. Both LBP and lumbar DD are common already in adolescence, but very little is known of their association in young adults.Methods. Young adults belonging to a birth cohort (n = 874) were invited to lumbar magnetic resonance imaging using a 1.5-T scanner. Data on LBP and functional limitations at the ages of 18, 19, and 21 years were used to cluster the subjects with respect to low back symptoms using latent class analysis. The prevalence and 95% confidence intervals of DD at 21 years and the sum score of DD at all lumbar levels were compared between the clusters. The contribution of DD and other imaging findings (herniations, anular tears, Modic changes, spondylolytic defects) to symptom severity was analyzed with logistic regression analysis.Results. Latent class analysis produced five clusters from the 554 subjects, ranging from a cluster where subjects (n = 65) had been painful at all time points to an asymptomatic cluster (n = 168). DD was more prevalent in the three most symptomatic clusters compared to the two least symptomatic ones. Similar findings were obtained for the DD sum scores. Lumbar DD was related to symptom severity independently of other degenerative findings. Moreover, moderately degenerated discs were more likely than mildly degenerated discs to be associated with the most severe low back symptoms.Conclusion. Intervertebral DD was associated with low back symptom severity among young adults, suggesting that the symptoms may have a discogenic origin at this age. However, DD was also found in one-third of asymptomatic subjects.