Severity of thoracic intervertebral disc degeneration increases with age

Mohamed Kamal Mesregah

The severity of thoracic intervertebral disc (IVD) degeneration and the number of degenerated levels increase with age, according to a new study published in the European Spine Journal.

The findings, published by Mohamed Kamal Mesregah (Keck School of Medicine of USC, California, USA) et al, also found that disc degeneration was more accelerated in the mid-thoracic spine and that adjacent-level degeneration was more common than skip-level degenerations.

The magnetic resonance imaging (MRI) study aimed to analyse the trends and patterns of IVD degeneration in different age groups at each level of the thoracic spine and included 1,000 symptomatic patients who had undergone upright thoracic spine MRI.

A total of 13,000 thoracic IVDs from C7/T1 to T12/L1 were classified into five grades using Pfirrmann classification. Patients were divided according to their ages into five groups.

The severity and pattern of IVD degeneration were analysed in each age group and a predictive model of the severity and pattern of IVD degeneration in each age group was proposed.

The MRI study showed that the total grade of IVD degeneration and the number of degenerated levels increased with increasing age (P < 0.001).

The most common degenerated level was T6/7 (13.3%), while the least common degenerated level was T12/L1 (1.8%). The most common grades were grade I in group 1 (60.5%), grade II in groups 2 (39%) and 3 (37.3%), and grade III in groups 4 (42.5%) and 5 (44.6%).

Speaking to Spinal News International, Mesregah said: “The pattern and severity of age-related thoracic IVD degenerative changes are poorly understood. Studying these changes in 1,000 symptomatic patients provided a way of predicting the severity of degeneration at each level of the thoracic spine in different age groups.

“In addition to studying the thoracic spine, our study looked at the cervicothoracic junction as well as the thoracolumbar junction, which was found to be the least frequent to degenerate.

“The findings of this study should raise the awareness of thoracic IVD degeneration as a possible cause of back pain and disability, especially in the mid-thoracic region, among spine practitioners.”


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