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Chiropractic Research Review

Identifying Degenerative Changes in the Cervical Spine as Individuals Age

Degenerative changes in the cervical spine are an inevitable and expected aspect of the human aging process.

Researchers and clinicians are interested in the degree to which this process is natural and normal.

The authors of this study state that their purpose was "to identify normal degenerative morphologic evolution in the bony foramen in asymptomatic people grouped by decade in comparison with symptomatic people of like decade." They hoped to better understand what predisposes some individuals "to stenosis and therefore radiculopathy."

The study recognized that the choice of imaging method to detect foraminal stenosis is a matter of some controversy. The authors explained their use of magnetic resonance imaging (MRI), saying that although computed tomagraphy (CT) is useful in detecting bony abnormalities, "an advantage of using MRI is that images may be acquired with equal clarity in any orientation: axial, sagittal, coronal, or oblique. In addition, there is no exposure to ionizing radiation, and contrast agents are not required in most cases."

Five to six symptomatic and asymptomatic people in each decade (from ages 20 to 60) were studied to obtain these results: "Foraminal height affects overall foriminal area but tends to change little with age." But "there are significant differences in foraminal measurements between symptomatic and asymptomatic people" and "analysis of morphology determined that the normal aging process causes the width of the foramen to decrease, reducing the area available for the nerve root, which may result in stenosis and radiculopathy."

Humphreys SC, Hodges SD, Patwardhan A, et al. The natural history of the cervical foramen in symptomatic and asymptomatic individuals aged 20-60 years as measured by magnetic resonance imaging. Spine, Oct. 15, 1998;23(20), pp2180-84.

Chiropractic Research Review

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