introduced a numerical scoring system for cervical disc degeneration based on lateral radiographs, which was not only substantial for the overall degree of disc degeneration, but also almost perfect for the single items. introduced a more sophisticated grading system that includes specific parameters, such as disc height loss, endplate sclerosis, and osteophyte formation and investigated the prevalence of degenerative changes in 200 asymptomatic people aged 20–65 years. In 1957, Kellgren and Lawrence proposed a grading system in which the degenerative condition was graded as ‘‘minimal”, ‘‘moderate’’ or ‘‘severe’’. Therefore, given the importance of radiographic disc degeneration to be used as a clinical reference, a better and more precise understanding of the characteristics of cervical disc degeneration based on plain radiographs is essential.īased on cervical lateral x-ray images, several scoring schemes for cervical disc degeneration have been reported. Additionally, radiographic degenerative phenotypes such as disc height loss, osteophyte formation or endplate sclerosis have been applied widely for diagnosis of the adjacent segment degeneration/disease following anterior cervical decompression and fusion. neck pain) or the effect of disc degeneration on spinal kinematics. For example, it would be helpful to assess the relation between the cervical disc degeneration and clinical symptoms (e.g. Knowledge of the characteristics of cervical disc degeneration based on plain radiographs may have relevant implications. recommended that standing cervical lateral radiographs should be obtained for all patients before surgery, since the cervical sagittal alignment in the standing posture is essential for the pre-operative planning, but is not accessible by means of other imaging modalities such as computed tomography (CT) and MRI. Although degeneration is most commonly assessed on magnetic resonance imaging (MRI), conventional plain radiography has several advantages over this imaging modality, such as cost-effectiveness, simplicity, as well as the capability of acquiring cervical sagittal alignment under weight-bearing conditions. X-rays) and has been described before both in symptomatic and asymptomatic people. Furthermore, the correlations between age and the degree of degenerative findings were stronger at C5/C6 and C6/C7 than at other cervical spinal levels.Ĭervical intervertebral disc degeneration is one of the most relevant clinical findings which can be extracted from cervical plain radiographs (i.e. Older age was associated with greater number of degenerated disc levels. The presence and severity of radiographic disc degeneration increased with aging in the cervical spine. The number of degenerated levels was also associated with age. Contiguous levels degeneration pattern was more likely found than skipped level degeneration. Age was significantly correlated with radiographic degenerative findings. The most frequent and severe occurrences of height loss, osteophyte formation, and endplate sclerosis were at C5/C6, whereas spondylolisthesis was most observed at C4/C5. The presence and severity of disc degeneration were found to be significantly associated with age both in male and female subjects. Resultsĥ3.9% of individuals had radiographic disc degeneration and the most affected level was C5/C6. The prevalence and distribution of radiographic findings were evaluated and associations with age were investigated. Cervical disc degeneration was graded from C2/C3 to C6/C7 based on a validated quantitative grading system. Standard lateral cervical spine radiographs in standing, neutral position of 1581 consecutive patients (723 males, 858 females) with an average age of 41.2 ± 18.2 years were evaluated. MethodsĪ retrospective study was performed. The aims of this study were (1) to determine the prevalence of radiographic cervical disc degeneration in a large population of patients aged from 18 to 97 years (2) to investigate individually the prevalence and distribution of height loss, osteophyte formation, endplate sclerosis and spondylolisthesis and (3) to describe the patterns of cervical disc degeneration.
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