The Distribution Of Lumbar Disc Degeneration In Degenerative Lumbar Disease And Its Related Factors

ObjectiveThe study made a research on 503 cases to evaluate the distribution of lumbar disc degeneration in degenerative lumbar disease and its related factors.MethodsWe made a retrospective analysis on 503 cases with lumbar and/or leg pain,and made statistics respectively on the clinical and imaging data by age,gender,course of disease,manual labor,disc segments and grade of lumbar disc degeneration in our hospital from January 2012 to February 2015.Then we analyzed the distribution of the characteristics and its related factors of lumbar disc degeneration to assess the stability,Modic changes,high-intensity zones,and Schmorl’s nodes of lumbar disc levels.All of 503 patients were examined by X-ray and MRI scan and they were exectly dignosed with degenerated lumbar disc disease.The patients who suffered from neurological and psychotic disorders,infection,tuberculosis,tumor and severe osteoporosis,history of trauma or operation were all excluded.And the patients that suffered ankylosing spondylitis or congenital spinal deformity were also excluded.We made statistics by SPSS 19.0 software.Results74.8%(1 863)of 2 515 discs in 503 cases had degeneration before operation,L1-2:52.1%(262),L2-3: 61.9%(311),L3-4: 74.0%(372),L4-5: 92.8%(467),L5-S1: 89.7%(451).There were 2 515 lumbar intervertebral discs,Pfirrmann radiographic grade Ⅰ:104,Ⅱ:548,Ⅲ:961,Ⅳ:825,Ⅴ:77;and there were 127 unstable segments,188 Modic changes,241 high-intensity zones,161 Schmorl’s nodes.The incidence of lumbar disc degeneration in patients with lumbar and/or leg pain is high.We found significant difference in distribution of lumbar disc degeneration between genders(P<0.01),and younger patients had a higher incidence,males’ was 37.4%,females’ was 27.3%.Young patients,especiallybefore the age of 30,the incidence of adult males with lumbar disc degeneration was higher compared with that of adult females.We also found age was an important factor of lumbar disc degeneration,the incidence and severity of degeneration increased with aging(P<0.01).The distribution of lumbar instability,Modic changes,HIZ and SN in different segment showed significant difference in different intervertebral segments(P<0.01).Course of disease,labour intensity,lumbar instability,Modic changes,high-intensity zones and Schmorl’s nodes were all correlated with lumbar disc degeneration.The incidence of degeneration in adjacent segments was high when L3-S1 discs degenerated.Conclusion1.Females had a higher incidence of lumbar disc degeneration.Young patients,especially before the age of 30,the incidence of adult males with lumbar disc degeneration was higher compared with that of adult females.2.Lumbar instability,Modic changes,high-intensity zones and Schmorl’s nodes were correlated with lumbar disc degeneration.3.The incidence of degeneration in adjacent segments was high when L3-S1 discs degenerated.4.The phenomenon that degeneration in adjacent segments widely existed in degenerative lumbar disease.We were expected to lay emphosis on the phenomenon.