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Osteoarthritis Cartilage. 2017 Jul;25(7):1122-1131. doi: 10.1016/j.joca.2017.01.001. Epub 2017 Jan 13.

Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal population-based cohort: the Wakayama Spine Study.

Author information

1
Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
2
Department of Joint Disease Research, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
3
Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan. Electronic address: hashizum@wakayama-med.ac.jp.
4
Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
5
Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan.
6
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
7
Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa City, Saitama, Japan.

Abstract

OBJECTIVE:

The present study examined the progression, incidence, and risk factors for intervertebral disc degeneration (DD) throughout the lumbar spine using magnetic resonance imaging (MRI) in a large population-based cohort.

METHODS:

We followed up 617 subjects for more than 4 years as part of the Wakayama Spine Study. 1) "Progression of DD" in each of the entire, upper (L1/2 to L3/4) and lower (L4/5 and L5/S1) lumbar spine was defined as Pfirrmann grade progression at follow-up in at least one disc in the affected region. 2) "Incidence of DD" in each of these regions was defined if all discs were grade 3 or lower (white disc) at baseline, and at least one disc had progressed to grade 4 or higher (black disc) at follow-up. Logistic regression analyses were used to determine the risk factors for progression and incidence of DD.

RESULTS:

DD progression and incidence in the entire lumbar spine were 52.0% and 31.6% in men, and 60.4% and 44.7% in women, respectively. Women was associated with DD progression in the upper lumbar spine (odds ratio [OR] = 1.68, 95% confidence interval [CI] = 1.18-2.42). Aging was associated with the incidence of DD in each region (entire: OR = 1.14, CI = 1.06-1.14; upper: OR = 1.10, CI = 1.05-1.15; lower: OR = 1.11, CI = 1.05-1.19). Diabetes mellitus (DM) was associated with the incidence of DD in the upper lumbar spine (OR = 6.83, CI = 1.07-133.7).

CONCLUSION:

This 4-year longitudinal study is the first to demonstrate DD progression and incidence in the lumbar spine and their risk factors in a large population-based cohort.

KEYWORDS:

Aging; Diabetes mellitus; Epidemiology; Incidence; Intervertebral disc degeneration; Longitudinal large population cohort; Progression; ROAD study

PMID:
28089899
DOI:
10.1016/j.joca.2017.01.001
[Indexed for MEDLINE]
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