A study from 2015 gives a great perspective on imaging of the spine. It is an amalgamation of 33 articles, providing a sample of 3110 people.
The interesting thing is that these people are all asymptomatic. That is, they have no pain.
They worked out an estimate of the prevalence of particular findings for specific age groups from the data.
The conclusion is that imaging evidence of degenerative spine disease is common in asymptomatic individuals and increases with age.
The findings suggest that may imaging-based degenerative features may be a part of normal aging and unassociated with low back pain, especially when incidentally seen.
It really drives home the idea that any imaging findings must be interpreted in the context of the patient’s clinical condition.
For example, a finding of disc degeneration at the age of 60 years old must be considered to be quite expected if the rate is 88% in a painfree population.
Find your age and prevalence on the graph – it makes for interesting reading!!
| 20yo | 30yo | 40yo | 50yo | 60yo | 70yo | 80yo | |
Disc degeneration |
37 |
52 |
68 |
80 |
88 |
93 |
96 |
| Disc signal loss |
17 |
33 |
54 |
73 |
86 |
94 |
97 |
| Disc height loss |
24 |
34 |
45 |
56 |
67 |
76 |
84 |
| Disc bulge |
30 |
40 |
50 |
60 |
69 |
77 |
84 |
| Disc protrusion |
29 |
31 |
33 |
36 |
38 |
40 |
43 |
| Annular fissure |
19 |
20 |
22 |
23 |
25 |
27 |
29 |
| Facet degeneration |
4 |
9 |
18 |
32 |
50 |
69 |
83 |
| Spondylolisthesis |
3 |
5 |
8 |
14 |
23 |
35 |
50 |
Reference
Brinjikji et al (2015) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal Of Neuroradiology
