96% Over 80yo Exhibit Signs of Spinal Degeneration Despite No Pain, Research Shows.
Findings suggest many imaging results are normal age-related changes, not pathological.
The study titled "Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations" (PMID: 25430861) examines the prevalence of various degenerative spine conditions as observed through imaging techniques (CT and MRI) in individuals without back pain.
Key Points
Objective: To systematically review the literature and estimate the prevalence of degenerative spine conditions by age in asymptomatic individuals.
Methodology: The study involved a comprehensive search of articles published up to April 2014, focusing on studies that reported imaging findings in asymptomatic populations. A total of 33 articles were included, encompassing 3,110 individuals.
Findings: The prevalence of various degenerative conditions was assessed across different age groups (20s to 80s).
Key Findings
Disk Degeneration:
Prevalence increased significantly with age, from 37% in individuals aged 20 to 96% in those aged 80.
Disk Bulge:
Found in 30% of individuals aged 20, rising to 84% by age 80.
Disk Protrusion:
Increased from 29% at age 20 to 43% at age 80.
Annular Fissures:
Prevalence rose from 19% at age 20 to 29% at age 80.
Facet Degeneration and Spondylolisthesis:
Facet degeneration was rare in younger individuals but increased sharply with age. Spondylolisthesis was uncommon until the age of 60, where it was found in 23% of cases.
Practical Takeaways
Normal Ageing Process: The study suggests that many degenerative changes observed through imaging are likely part of the normal ageing process, rather than indicators of pathology requiring intervention.
Clinical Implications: Clinicians should interpret imaging findings cautiously, especially in asymptomatic patients, as these features may not correlate with pain or functional impairment.
Guidance for Imaging Interpretation: The results emphasise the importance of context when evaluating imaging reports. Incidental and common findings in older populations should not automatically lead to invasive procedures or treatments.
This systematic review provides valuable insights into the prevalence of spinal degeneration in asymptomatic individuals and highlights the need to interpret imaging results carefully in clinical practice.
Reference
Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. PMID: 25430861; PMCID: PMC4464797.