Radiographic features of lumbar disc degeneration and self-reported back pain

S. R. Pye, David M Reid, R. Smith, J. E. Adams, Kennedy Muturi Nelson, A. J. Silman, T. W. O'Neill

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Objective. To characterize the occurrence of radiographic features of lumbar disc degeneration including the presence of osteophytes, endplate sclerosis, and disc space narrowing and to determine their relationship with self-reported back pain.

Methods. Subjects aged 50 years and over were recruited from a primary care based community health index in Aberdeen, UK. Subjects were invited to complete an interviewer administered questionnaire and to have lateral spinal radiographs performed. The questionnaire included questions concerning the occurrence of back pain, both ever and in the past year. The inter-vertebral disc spaces (L1/2 to L4/5) were evaluated for the presence and severity of anterior osteophytes, endplate sclerosis, and disc space narrowing using a semi-quantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration (using for each feature, the most severely affected vertebra) and back pain, with adjustments made for age and gender.

Results. There were 286 men (mean age 65.3 years), and 299 women (mean age 65.2 years) with spinal radiographs. Osteophytes were the most frequent radiographic feature. Osteophytes and endplate sclerosis were more frequent in men than women, but there was no gender difference in the frequency of disc space narrowing. All radiographic features increased in frequency with age; for osteophytes this was true only after excluding mild (grade 1) osteophytes. Compared to those without, those with disc space narrowing were more likely to report back pain both ever, [odds ratio (OR) = 2.1; 95% confidence interval (CI): 1.5 to 3.0] and in the past year (OR = 1.7) with the strength of the association increasing with increasing severity of narrowing. Endplate sclerosis was not linked with back pain although moderate (grade 2) sclerosis was associated with back pain, both ever and in the past year. Compared to those without, or those with mild osteophytes, those with more severe osteophytes.(grade > 1) were more likely to report back pain ever (OR = 1.7; 95% CI: 1.2 to 2.5).

Conclusion. These data highlight the frequent occurrence, and the increase in frequency with age, of the individual radiographic features of lumbar disc degeneration in population samples of men and women. Disc space narrowing appeared more strongly associated with back pain than the other radiographic features.

Original languageEnglish
Pages (from-to)753-758
Number of pages5
JournalJournal of Rheumatology
Volume31
Issue number4
Publication statusPublished - 2004

Keywords

  • epidemiology
  • disc degeneration
  • lumbar spine
  • back pain
  • individual radiographic features
  • VERTEBRAL OSTEOPOROSIS
  • WOMEN
  • MEN
  • OSTEOARTHRITIS
  • SPINE

Cite this

Pye, S. R., Reid, D. M., Smith, R., Adams, J. E., Nelson, K. M., Silman, A. J., & O'Neill, T. W. (2004). Radiographic features of lumbar disc degeneration and self-reported back pain. Journal of Rheumatology, 31(4), 753-758.

Radiographic features of lumbar disc degeneration and self-reported back pain. / Pye, S. R.; Reid, David M; Smith, R.; Adams, J. E.; Nelson, Kennedy Muturi; Silman, A. J.; O'Neill, T. W.

In: Journal of Rheumatology, Vol. 31, No. 4, 2004, p. 753-758.

Research output: Contribution to journalArticle

Pye, SR, Reid, DM, Smith, R, Adams, JE, Nelson, KM, Silman, AJ & O'Neill, TW 2004, 'Radiographic features of lumbar disc degeneration and self-reported back pain', Journal of Rheumatology, vol. 31, no. 4, pp. 753-758.
Pye SR, Reid DM, Smith R, Adams JE, Nelson KM, Silman AJ et al. Radiographic features of lumbar disc degeneration and self-reported back pain. Journal of Rheumatology. 2004;31(4):753-758.
Pye, S. R. ; Reid, David M ; Smith, R. ; Adams, J. E. ; Nelson, Kennedy Muturi ; Silman, A. J. ; O'Neill, T. W. / Radiographic features of lumbar disc degeneration and self-reported back pain. In: Journal of Rheumatology. 2004 ; Vol. 31, No. 4. pp. 753-758.
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abstract = "Objective. To characterize the occurrence of radiographic features of lumbar disc degeneration including the presence of osteophytes, endplate sclerosis, and disc space narrowing and to determine their relationship with self-reported back pain.Methods. Subjects aged 50 years and over were recruited from a primary care based community health index in Aberdeen, UK. Subjects were invited to complete an interviewer administered questionnaire and to have lateral spinal radiographs performed. The questionnaire included questions concerning the occurrence of back pain, both ever and in the past year. The inter-vertebral disc spaces (L1/2 to L4/5) were evaluated for the presence and severity of anterior osteophytes, endplate sclerosis, and disc space narrowing using a semi-quantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration (using for each feature, the most severely affected vertebra) and back pain, with adjustments made for age and gender.Results. There were 286 men (mean age 65.3 years), and 299 women (mean age 65.2 years) with spinal radiographs. Osteophytes were the most frequent radiographic feature. Osteophytes and endplate sclerosis were more frequent in men than women, but there was no gender difference in the frequency of disc space narrowing. All radiographic features increased in frequency with age; for osteophytes this was true only after excluding mild (grade 1) osteophytes. Compared to those without, those with disc space narrowing were more likely to report back pain both ever, [odds ratio (OR) = 2.1; 95{\%} confidence interval (CI): 1.5 to 3.0] and in the past year (OR = 1.7) with the strength of the association increasing with increasing severity of narrowing. Endplate sclerosis was not linked with back pain although moderate (grade 2) sclerosis was associated with back pain, both ever and in the past year. Compared to those without, or those with mild osteophytes, those with more severe osteophytes.(grade > 1) were more likely to report back pain ever (OR = 1.7; 95{\%} CI: 1.2 to 2.5).Conclusion. These data highlight the frequent occurrence, and the increase in frequency with age, of the individual radiographic features of lumbar disc degeneration in population samples of men and women. Disc space narrowing appeared more strongly associated with back pain than the other radiographic features.",
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T1 - Radiographic features of lumbar disc degeneration and self-reported back pain

AU - Pye, S. R.

AU - Reid, David M

AU - Smith, R.

AU - Adams, J. E.

AU - Nelson, Kennedy Muturi

AU - Silman, A. J.

AU - O'Neill, T. W.

PY - 2004

Y1 - 2004

N2 - Objective. To characterize the occurrence of radiographic features of lumbar disc degeneration including the presence of osteophytes, endplate sclerosis, and disc space narrowing and to determine their relationship with self-reported back pain.Methods. Subjects aged 50 years and over were recruited from a primary care based community health index in Aberdeen, UK. Subjects were invited to complete an interviewer administered questionnaire and to have lateral spinal radiographs performed. The questionnaire included questions concerning the occurrence of back pain, both ever and in the past year. The inter-vertebral disc spaces (L1/2 to L4/5) were evaluated for the presence and severity of anterior osteophytes, endplate sclerosis, and disc space narrowing using a semi-quantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration (using for each feature, the most severely affected vertebra) and back pain, with adjustments made for age and gender.Results. There were 286 men (mean age 65.3 years), and 299 women (mean age 65.2 years) with spinal radiographs. Osteophytes were the most frequent radiographic feature. Osteophytes and endplate sclerosis were more frequent in men than women, but there was no gender difference in the frequency of disc space narrowing. All radiographic features increased in frequency with age; for osteophytes this was true only after excluding mild (grade 1) osteophytes. Compared to those without, those with disc space narrowing were more likely to report back pain both ever, [odds ratio (OR) = 2.1; 95% confidence interval (CI): 1.5 to 3.0] and in the past year (OR = 1.7) with the strength of the association increasing with increasing severity of narrowing. Endplate sclerosis was not linked with back pain although moderate (grade 2) sclerosis was associated with back pain, both ever and in the past year. Compared to those without, or those with mild osteophytes, those with more severe osteophytes.(grade > 1) were more likely to report back pain ever (OR = 1.7; 95% CI: 1.2 to 2.5).Conclusion. These data highlight the frequent occurrence, and the increase in frequency with age, of the individual radiographic features of lumbar disc degeneration in population samples of men and women. Disc space narrowing appeared more strongly associated with back pain than the other radiographic features.

AB - Objective. To characterize the occurrence of radiographic features of lumbar disc degeneration including the presence of osteophytes, endplate sclerosis, and disc space narrowing and to determine their relationship with self-reported back pain.Methods. Subjects aged 50 years and over were recruited from a primary care based community health index in Aberdeen, UK. Subjects were invited to complete an interviewer administered questionnaire and to have lateral spinal radiographs performed. The questionnaire included questions concerning the occurrence of back pain, both ever and in the past year. The inter-vertebral disc spaces (L1/2 to L4/5) were evaluated for the presence and severity of anterior osteophytes, endplate sclerosis, and disc space narrowing using a semi-quantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration (using for each feature, the most severely affected vertebra) and back pain, with adjustments made for age and gender.Results. There were 286 men (mean age 65.3 years), and 299 women (mean age 65.2 years) with spinal radiographs. Osteophytes were the most frequent radiographic feature. Osteophytes and endplate sclerosis were more frequent in men than women, but there was no gender difference in the frequency of disc space narrowing. All radiographic features increased in frequency with age; for osteophytes this was true only after excluding mild (grade 1) osteophytes. Compared to those without, those with disc space narrowing were more likely to report back pain both ever, [odds ratio (OR) = 2.1; 95% confidence interval (CI): 1.5 to 3.0] and in the past year (OR = 1.7) with the strength of the association increasing with increasing severity of narrowing. Endplate sclerosis was not linked with back pain although moderate (grade 2) sclerosis was associated with back pain, both ever and in the past year. Compared to those without, or those with mild osteophytes, those with more severe osteophytes.(grade > 1) were more likely to report back pain ever (OR = 1.7; 95% CI: 1.2 to 2.5).Conclusion. These data highlight the frequent occurrence, and the increase in frequency with age, of the individual radiographic features of lumbar disc degeneration in population samples of men and women. Disc space narrowing appeared more strongly associated with back pain than the other radiographic features.

KW - epidemiology

KW - disc degeneration

KW - lumbar spine

KW - back pain

KW - individual radiographic features

KW - VERTEBRAL OSTEOPOROSIS

KW - WOMEN

KW - MEN

KW - OSTEOARTHRITIS

KW - SPINE

M3 - Article

VL - 31

SP - 753

EP - 758

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 4

ER -