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Spine J. 2018 Nov;18(11):2065-2073. doi: 10.1016/j.spinee.2018.04.010. Epub 2018 Apr 19.

A longitudinal study of disc height narrowing and facet joint osteoarthritis at the thoracic and lumbar spine, evaluated by computed tomography: the Framingham Study.

Author information

1
Quantitative Imaging Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118, USA.
2
Institute for Aging Research, Hebrew SeniorLife, 1200 Center St, Boston, MA 02131, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.
3
Institute for Aging Research, Hebrew SeniorLife, 1200 Center St, Boston, MA 02131, USA.
4
Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, RN115, 330 Brookline Ave, Boston , MA 02215, USA; Department of Orthopedic Surgery, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
5
Department of Biostatistics and Epidemiology, Boston University School of Public Health, Crosstown Building, 801 Massachusetts Ave, 3rd Floor, Boston, MA 02118, USA; Framingham Heart Study, 73 Mt Wayte Ave, Framingham, MA, 01702, USA.
6
Institute for Aging Research, Hebrew SeniorLife, 1200 Center St, Boston, MA 02131, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA. Electronic address: samelson@hsl.harvard.edu.

Abstract

BACKGROUND CONTEXT:

Prevalence and progression of disc height narrowing (DHN) and facet joint osteoarthritis (FJOA) in the thoracic and lumbar regions in non-clinical populations are not well established.

PURPOSE:

The present study aimed to use computed tomography (CT) images to determine the prevalence and progression of DHN and FJOA according to age, sex, and spinal region.

STUDY DESIGN:

This is a 6-year longitudinal study.

SAMPLE:

A total of 1,195 members of the Framingham Study (mean baseline age 61±9 years) were included in the study.

OUTCOME MEASURES:

We compared the prevalence and progression (new or worsening) of moderate-to-severe DHN and FJOA by age, sex, and spinal region.

METHODS:

A musculoskeletal radiologist evaluated DHN and FJOA from T4/T5 to L4/L5 on baseline and follow-up CT images using a semi-quantitative scale: 0=normal, 1=mild, 2=moderate, and 3=severe.

RESULTS:

One-third or more of women and men ages 40-59 years at baseline had imaged-based evidence of prevalent DHN, more than half had prevalent FJOA, and DHN and FJOA prevalence increased approximately two- to fourfold in those age 60-69 and 70-89 years at baseline, respectively (p<.01). Progression of DHN and FJOA occurred more frequently at the lumbar than at the thoracic spine and more in women than in men (DHN: odds ratio [OR]=1.42, 95% confidence interval [CI]=1.07, 1.88; FJOA: OR=1.70, CI=1.33, 2.17).

CONCLUSIONS:

Prevalence and progression of moderate-to-severe DHN and FJOA are common in non-clinical populations of older adults. The high frequency of spinal degeneration observed on CTs in this community-based study may contribute to challenges in interpreting the clinical significance of imaging evidence of DHN and FJOA. Future studies investigating the association of CT-based spinal degenerative features with pain and functional impairments in population-based samples are needed to help determine the clinical significance of imaged-based findings of DHN and FJOA.

KEYWORDS:

Aging spine; Disc height; Epidemiology; Facet joint; Longitudinal study; Osteoarthritis

PMID:
29679729
PMCID:
PMC6195485
[Available on 2019-11-01]
DOI:
10.1016/j.spinee.2018.04.010

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