Does lumbar spinal degeneration start with the front structures?
Author Information
Author(s): Suri Pradeep, Miyakoshi Asako, Hunter David J, Jarvik Jeffrey G, Rainville James, Guermazi Ali, Li Ling, Katz Jeffrey N
Primary Institution: VA Boston Healthcare System
Hypothesis
Is spinal degeneration initiated by changes in the anterior structures of the lumbar spine?
Conclusion
Most individuals show that lumbar spinal degeneration begins with the anterior structures, although some exhibit atypical patterns starting in the posterior joints.
Supporting Evidence
- The study included 361 participants from the Framingham Heart Study.
- CT imaging was used to assess degeneration patterns.
- Isolated posterior degeneration was most common at the L5-S1 and L4-L5 levels.
- Increased age, female sex, and higher BMI were associated with posterior degeneration.
Takeaway
This study looked at people's backs to see if problems start in the front or back parts. Most people had issues starting in the front, but some had problems starting in the back.
Methodology
Participants were assessed for spinal degeneration using CT imaging, categorizing them into four degeneration patterns and analyzing associations with demographic factors.
Potential Biases
Selection bias may exist due to the community-based sample, but the study aimed to reduce confounding factors.
Limitations
The study's cross-sectional design limits causal conclusions, and the use of CT imaging may miss early disk changes.
Participant Demographics
Mean age was 57.0 years, 46.5% were female, and the mean BMI was 28.0.
Statistical Information
P-Value
0.0004
Confidence Interval
95% CI 1.15-3.25
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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