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THE PREVALENCE OF THORACIC DISC DEGENERATION IN MEN



Abstract

Purpose & Relevance: To examine the prevalence of degenerative findings in the thoracic spine in a population sample of adult men. Normative data on thoracic degenerative findings provide an essential reference for related observations in patients.

Methods & Results: Qualitative and quantitative assessments of thoracic disc degeneration were obtained from MRI (levels T6-L1) for general population sample of 532 men aged 25–70 years. Qualitative assessments of disc degeneration were performed by an experienced spine surgeon and custom-made software was used to acquire quantitative assessments. Descriptive statistics were acquired using SPSS. Moderate or severe disc bulging was present in at least one disc in 7.9% of subjects, with bulging most common at the two lowest levels. The prevalence of disc herniations was 0.8%. Moderate or severe disc height narrowing was present in 2.7% to 9.7% by disc level with 22.4% of subjects having at least one narrowed disc. Four or more wedged vertebrae (≥ 5°) were present in 68 subjects and 13 (2.4%) had coexisting Schmorl’s nodes. Seven subjects (1.3%) met more stringent criteria for Scheuermann’s disease, with three or more wedged vertebrae, endplate changes, sclerosis and disc height narrowing. Of the variables examined, disc signal intensity correlated highest with age (r= 0.31–0.40, depending on disc level).

Conclusion: The prevalence of disc degeneration appears lower in the thoracic spine than previously reported in the lumbar spine. However, one-fifth of the subjects have markedly narrowed discs, which have been associated with symptom history in the lumbar spine. Disc signal intensity is the finding most highly associated with age.

Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.