Link between Atherosclerosis and Disc Disease?
Evidence suggests that insufficient blood supply may contribute to disc degeneration. This potential causative relationship is supported by studies in which smoking (a known risk factor for arterial disease) correlated with low back pain, raising the question of whether arteriosclerosis itself may be a precursor of lumbar disc degeneration and/or disease.
From 1991-1993, computed tomographic (CT) discography was performed on 29 patients (21-58 years of age) as part of a study designed to evaluate whether atherosclerotic lesions in the abdominal aorta were more prominent in patients with low back pain (LBP) vs. those without such pain. The study also served to explore whether plaque buildup in the aorta correlated with the degree of disc damage. A second group of patients (52 patients without low back pain) served as controls. Results are presented as follows:
* 55% of patients with low back pain had atherosclerotic lesions visible on CT scan vs. only 21% of patients without LBP.
* 48% of patients under 50 years of age with LBP had aortic damage, compared with 8% of similar pain-free controls.
* No correlation was noted between the degree of aortic atherosclerosis and the degree of disc damage as assessed by CT discography.
The authors conclude that a significant association exists between low back pain and atherosclerotic lesions in the abdominal aorta. They believe this association may be caused by inadequate blood flow to the disc area or may serve as an indication of common factors between arterial disease and disc degeneration.
Kurunlahti M, Tervonen O, Vanharanta H, et al. Association of atherosclerosis with low back pain and the degree of disc degeneration. Spine
, Oct. 15, 1999:24(20), pp2080-84.