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Article: Intervertebral disc degeneration: New insights based on "skipped" level disc pathology

TitleIntervertebral disc degeneration: New insights based on "skipped" level disc pathology
Authors
Issue Date2010
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0004-3591/
Citation
Arthritis And Rheumatism, 2010, v. 62 n. 8, p. 2392-2400 How to Cite?
AbstractObjective. Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD). Methods. As part of a large genetics-based study in southern Chinese individuals (n = 1,989), a crosssectional analysis was performed in subjects exhibiting disc degeneration in ≥2 levels (n = 838) who were then categorized as having SLDD (n = 174) or non-SLDD (contiguous, multilevel; n = 664). Various radiographic parameters were assessed based on T2-weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed. Results. Overall, 8.7% of the whole population (n = 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n = 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04-2.10, P = 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78-4.15, P < 0.001), which also presented in levels with no disc degeneration. A history of disc bulge/extrusion (P = 0.004) and/or a history of back injury (P = 0.010) was significantly associated with non-SLDD, and a greater degree of overall severity of disc degeneration was also associated with non-SLDD. Other demographic and MRI findings did not significantly differ between groups. Conclusion. To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration. © 2010, American College of Rheumatology.
Persistent Identifierhttp://hdl.handle.net/10722/142324
ISSN
2015 Impact Factor: 8.955
2015 SCImago Journal Rankings: 3.206
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong Area of Excellence programAoE/M-04/04
Pfizer
Merck
Sharp
Dohme
Novartis
Roche
Funding Information:

Supported by the Hong Kong Area of Excellence program (grant AoE/M-04/04).

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorKarppinen, Jen_HK
dc.contributor.authorMok, FPSen_HK
dc.contributor.authorHo, DWHen_HK
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorLuk, KDKen_HK
dc.date.accessioned2011-10-28T02:43:01Z-
dc.date.available2011-10-28T02:43:01Z-
dc.date.issued2010en_HK
dc.identifier.citationArthritis And Rheumatism, 2010, v. 62 n. 8, p. 2392-2400en_HK
dc.identifier.issn0004-3591en_HK
dc.identifier.urihttp://hdl.handle.net/10722/142324-
dc.description.abstractObjective. Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD). Methods. As part of a large genetics-based study in southern Chinese individuals (n = 1,989), a crosssectional analysis was performed in subjects exhibiting disc degeneration in ≥2 levels (n = 838) who were then categorized as having SLDD (n = 174) or non-SLDD (contiguous, multilevel; n = 664). Various radiographic parameters were assessed based on T2-weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed. Results. Overall, 8.7% of the whole population (n = 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n = 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04-2.10, P = 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78-4.15, P < 0.001), which also presented in levels with no disc degeneration. A history of disc bulge/extrusion (P = 0.004) and/or a history of back injury (P = 0.010) was significantly associated with non-SLDD, and a greater degree of overall severity of disc degeneration was also associated with non-SLDD. Other demographic and MRI findings did not significantly differ between groups. Conclusion. To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration. © 2010, American College of Rheumatology.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0004-3591/en_HK
dc.relation.ispartofArthritis and Rheumatismen_HK
dc.rightsArthritis & Rheumatism. Copyright © John Wiley & Sons, Inc.-
dc.subject.meshAged, 80 and over-
dc.subject.meshIntervertebral Disk Degeneration - classification - epidemiology - radiography-
dc.subject.meshLumbar Vertebrae - radiography-
dc.subject.meshSeverity of Illness Index-
dc.subject.meshSex Factors-
dc.titleIntervertebral disc degeneration: New insights based on "skipped" level disc pathologyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-3591&volume=62&issue=8&spage=2392&epage=2400&date=2010&atitle=Invertebral+disc+degeneration:+new+insights+based+on+%27skipped%27+level+disc+pathology-
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_HK
dc.identifier.emailSamartzis, D: dspine@hku.hken_HK
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.emailLuk, KDK: hcm21000@hku.hken_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/art.27523en_HK
dc.identifier.pmid20506340-
dc.identifier.scopuseid_2-s2.0-77955405549en_HK
dc.identifier.hkuros196981en_US
dc.identifier.hkuros173075-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77955405549&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume62en_HK
dc.identifier.issue8en_HK
dc.identifier.spage2392en_HK
dc.identifier.epage2400en_HK
dc.identifier.eissn1529-0131-
dc.identifier.isiWOS:000282762100024-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectDevelopmental genomics and skeletal research-
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridKarppinen, J=7004560479en_HK
dc.identifier.scopusauthoridMok, FPS=36241964600en_HK
dc.identifier.scopusauthoridHo, DWH=23502006100en_HK
dc.identifier.scopusauthoridFong, DYT=35261710300en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK

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