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Chiropractic Research Review

MRI Imaging as an Indicator of Lumbar Disc Degeneration

Lumbar disc degeneration can be defined as decreased signal intensity on T2-weighted magnetic resonance images (MRI) in combination with a loss of disc space height. It has also been published that early disc degeneration can occur without a loss in disc height or decrease in MRI signal intensity.

There is evidence that physical loading can affect disc height and this study is part of a project designed to investigate the effects of occupational loading on disc degeneration of the lumbar spine. The purpose of this study was to compare the usefulness of disc height and T2-weighted signal intensity of the nucleus pulposus as indicators of lumbar disc degeneration.

Forty-one machine operators, 41 construction carpenters, and 46 office workers, aged 40-45 years, and 22 students aged 18-20 years, were examined with sagittal magnetic resonance imaging. All study participants were men. The mean value of the anterior and posterior disc height and the relative T2-weighted signal intensity of the nucleus pulposus of discs L2-L3 to L5-S1 were measured.

Young men showed the lowest disc height but the highest relative signal intensity. Disc height showed an increasing trend from the office workers (sedentary) to the blue-collar workers (physical work) at all disc levels but L5-S1. Relative signal intensity showed a decreasing trend for these same worker types at all levels. In generalized linear modeling, signal intensity and the occupations, in reference to the young students, showed a significant effect on disc height.

Conclusion: Relative signal intensity was lower in middle-aged men than in young men, indicating age-related disc degeneration. Despite the general positive association between disc narrowing and decreased relative signal intensity, disc narrowing may behave unexpectedly in relation to signal intensity and age. T2-weighted signal intensity of the nucleus pulposus may be a more sensitive measure of disc degeneration than disc height and the validity of disc height, as an indicator of early degeneration seems questionable.

It is possible that the results of this study and other studies in this project can help clinicians find early signs of lumbar disc degeneration on T2-weighted images.

Luoma K, Vehas T, Riihimaki H, et al. Disc height and signal intensity of the nucleus pulposus on magnetic resonance imaging as indicators of lumbar disc degeneration. Spine. 2001:26(6), pp. 680-686.

Chiropractic Research Review

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