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Conference Paper: Are patterns of lumbar disc degeneration associated with low back pain? New insights based on skipped level disc pathology

TitleAre patterns of lumbar disc degeneration associated with low back pain? New insights based on skipped level disc pathology
Authors
Issue Date2011
Citation
The 2011 Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), Goteborg, Sweden, 14-18 June 2011. How to Cite?
AbstractINTRODUCTION: The occurrence of SLDD of the lumbar spine has recently been noted. To date, patterns of disc degeneration have been overlooked in the association with LBP. The objective of this study was to evaluate the clinical relevance of skipped level disc degeneration (SLDD) to that of contiguous, multilevel lumbar disc degeneration (CMDD) of the lumbar spine. Secondly, the study aimed to identify patterns of SLDD, their classification, prevalence, and clinical relevance. METHODS: A population-based radiographic and clinical study of 3,099 Southern Chinese. Individuals with multilevel lumbar disc degeneration of the lumbar spine on sagittal T2-weighted MRI (N=1,457) were stratified to SLDD (n=301; 20.7%) or CMDD (n=1,156; 79.3%) groups. SLDD was further classified into five types by the relative location of non-degenerated normal disc(s) to degenerated disc levels. Subject demographics, presence of LBP, pain intensity and functional disability were assessed. RESULTS: CMDD increased the likelihood of historical LBP (OR: 1.39; 95% CI: 1.00-1.93; p=0.047) and pain severity (OR: 1.83; 95% CI: 1.23-2.73; p=0.003) in comparison to SLDD. A significant increasing trend of number of levels with disc degeneration, overall disc degeneration severity, and presence of disc bulges/extrusions was noted from SLDD Type I (least severe) to SLDD Type V (most severe) (p<0.05). A higher prevalence of LBP and a higher pain intensity was observed in SLDD classification Type V. Functional disability scores did not differ between CMDD and SLDD nor within SLDD classification-types (p>0.05). DISCUSSION: Our large-scale study is the first to describe novel variants of SLDD-types and their clinical relevance. LBP and severity of pain was more pronounced in individuals with CMDD. Subjects with similar degree but with different patterns of multilevel disc degeneration do differ with respect to low back symptoms. This finding may provide new evidence with regards to the mechanism of LBP.
DescriptionOral Presentation: P29
Full text link: http://journals.lww.com/spinejournalabstracts/Fulltext/2011/10001/Are_Patterns_of_Lumbar_Disc_Degeneration.286.aspx
Persistent Identifierhttp://hdl.handle.net/10722/137821

 

DC FieldValueLanguage
dc.contributor.authorSamartzis, Den_US
dc.contributor.authorKarppinen, Jen_US
dc.contributor.authorLuk, Ken_US
dc.contributor.authorCheung, Ken_US
dc.date.accessioned2011-08-26T14:34:30Z-
dc.date.available2011-08-26T14:34:30Z-
dc.date.issued2011en_US
dc.identifier.citationThe 2011 Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), Goteborg, Sweden, 14-18 June 2011.en_US
dc.identifier.urihttp://hdl.handle.net/10722/137821-
dc.descriptionOral Presentation: P29-
dc.descriptionFull text link: http://journals.lww.com/spinejournalabstracts/Fulltext/2011/10001/Are_Patterns_of_Lumbar_Disc_Degeneration.286.aspx-
dc.description.abstractINTRODUCTION: The occurrence of SLDD of the lumbar spine has recently been noted. To date, patterns of disc degeneration have been overlooked in the association with LBP. The objective of this study was to evaluate the clinical relevance of skipped level disc degeneration (SLDD) to that of contiguous, multilevel lumbar disc degeneration (CMDD) of the lumbar spine. Secondly, the study aimed to identify patterns of SLDD, their classification, prevalence, and clinical relevance. METHODS: A population-based radiographic and clinical study of 3,099 Southern Chinese. Individuals with multilevel lumbar disc degeneration of the lumbar spine on sagittal T2-weighted MRI (N=1,457) were stratified to SLDD (n=301; 20.7%) or CMDD (n=1,156; 79.3%) groups. SLDD was further classified into five types by the relative location of non-degenerated normal disc(s) to degenerated disc levels. Subject demographics, presence of LBP, pain intensity and functional disability were assessed. RESULTS: CMDD increased the likelihood of historical LBP (OR: 1.39; 95% CI: 1.00-1.93; p=0.047) and pain severity (OR: 1.83; 95% CI: 1.23-2.73; p=0.003) in comparison to SLDD. A significant increasing trend of number of levels with disc degeneration, overall disc degeneration severity, and presence of disc bulges/extrusions was noted from SLDD Type I (least severe) to SLDD Type V (most severe) (p<0.05). A higher prevalence of LBP and a higher pain intensity was observed in SLDD classification Type V. Functional disability scores did not differ between CMDD and SLDD nor within SLDD classification-types (p>0.05). DISCUSSION: Our large-scale study is the first to describe novel variants of SLDD-types and their clinical relevance. LBP and severity of pain was more pronounced in individuals with CMDD. Subjects with similar degree but with different patterns of multilevel disc degeneration do differ with respect to low back symptoms. This finding may provide new evidence with regards to the mechanism of LBP.-
dc.languageengen_US
dc.relation.ispartofAnnual Meeting of the International Society for the Study of the Lumbar Spineen_US
dc.titleAre patterns of lumbar disc degeneration associated with low back pain? New insights based on skipped level disc pathologyen_US
dc.typeConference_Paperen_US
dc.identifier.emailSamartzis, D: dspine@hku.hken_US
dc.identifier.emailLuk, K: hcm21000@hku.hken_US
dc.identifier.emailCheung, K: cheungmc@hku.hken_US
dc.identifier.authoritySamartzis, D=rp01430en_US
dc.identifier.authorityLuk, K=rp00333en_US
dc.identifier.hkuros189118en_US
dc.identifier.hkuros255987-

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