Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
    • COVID-19 Content and Resources
  • For Authors
    • Author Policies
    • Manuscript Submission Guidelines
  • About Us
    • About AJNR
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Podcasts
    • Subscribe on iTunes
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
    • COVID-19 Content and Resources
  • For Authors
    • Author Policies
    • Manuscript Submission Guidelines
  • About Us
    • About AJNR
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Podcasts
    • Subscribe on iTunes
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
Research ArticleSpine
Open Access

Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations

W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes and J.G. Jarvik
American Journal of Neuroradiology April 2015, 36 (4) 811-816; DOI: https://doi.org/10.3174/ajnr.A4173
W. Brinjikji
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
P.H. Luetmer
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B. Comstock
bDepartments of Biostatistics (B.C.)
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B.W. Bresnahan
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
L.E. Chen
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
R.A. Deyo
fDepartments of Family Medicine, Medicine, and Public Health and Preventive Medicine and the Oregon Institute of Occupational Health Sciences (R.A.D.), Oregon Health and Science University, Portland, Oregon
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
S. Halabi
gDepartment of Radiology (S.H.), Henry Ford Hospital, Detroit, Michigan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.A. Turner
dPsychiatry and Behavioral Sciences (J.A.T.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A.L. Avins
hDepartment of Radiology (A.L.A.), University of California, San Francisco, San Francisco, California
iDivision of Research (A.L.A.), Kaiser Permanente, Northern California, Oakland, California.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
K. James
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.T. Wald
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
D.F. Kallmes
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J.G. Jarvik
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
eNeurological Surgery and Health Services (J.G.J.), Comparative Effectiveness Cost and Outcomes Research Center, University of Washington, Seattle, Washington
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF
Loading

Abstract

BACKGROUND AND PURPOSE: Degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. We sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals.

MATERIALS AND METHODS: We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014. Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates. For each imaging finding, we fit a generalized linear mixed-effects model for the age-specific prevalence estimate clustering in the study, adjusting for the midpoint of the reported age interval.

RESULTS: Thirty-three articles reporting imaging findings for 3110 asymptomatic individuals met our study inclusion criteria. The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age.

CONCLUSIONS: Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient's clinical condition.

  • © 2015 by American Journal of Neuroradiology

Indicates open access to non-subscribers at www.ajnr.org

View Full Text
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 36 (4)
American Journal of Neuroradiology
Vol. 36, Issue 4
1 Apr 2015
  • Table of Contents
  • Index by author
  • Complete Issue (PDF)
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes, J.G. Jarvik
American Journal of Neuroradiology Apr 2015, 36 (4) 811-816; DOI: 10.3174/ajnr.A4173

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes, J.G. Jarvik
American Journal of Neuroradiology Apr 2015, 36 (4) 811-816; DOI: 10.3174/ajnr.A4173
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Abstract
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Taking patients to the ice cream shop but telling them that they cannot have ice cream: a qualitative study of orthopaedic spine clinicians perceptions of persistent low back pain consultations
  • Consumer understanding of terms used in imaging reports requested for low back pain: a cross-sectional survey
  • Patient, Provider, and Clinic Characteristics Associated with Opioid and Non-Opioid Pain Prescriptions for Patients Receiving Low Back Imaging in Primary Care
  • 'Scan-negative cauda equina syndrome: what to do when there is no neurosurgical cause
  • Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care
  • Infographic. When is abnormal normal? Reframing MRI abnormalities as a normal part of ageing
  • Chronic Low Back Pain Occurring in Association With Hypermobility Spectrum Disorder and Ehlers-Danlos Syndrome
  • Do not routinely offer imaging for uncomplicated low back pain
  • Protocol for disease-oriented Russian disc degeneration study (RuDDS) biobank facilitating functional omics studies of lumbar disc degeneration
  • Clinical management of acute low back pain in elite and subelite rowers: a Delphi study of experienced and expert clinicians
  • Low back pain in compensated Australian workers: a retrospective cohort study
  • Recognising and explaining functional neurological disorder
  • Biomechanical risk factors of lower back pain in cricket fast bowlers using inertial measurement units: a prospective and retrospective investigation
  • VAST Clinical Trial: Safely Supplementing Tissue Lost to Degenerative Disc Disease
  • Response to: 'Frequency of MRI changes suggestive of axial spondyloarthritis in the axial in a large population-based cohort of individuals aged <45 years by Parperis
  • Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis
  • Non-pharmacological treatment of low back pain in primary care
  • Genome-wide meta-analysis identifies genetic locus on chromosome 9 associated with Modic changes
  • Thoracolumbar intervertebral disc area morphometry in elderly Chinese men and women: radiographic quantifications at baseline and changes at year-4 follow-up
  • Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial
  • Red flag screening for low back pain: nothing to see here, move along: a narrative review
  • Poor overall quality of clinical practice guidelines for musculoskeletal pain: a systematic review
  • Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis
  • [18F]-Sodium Fluoride PET MR-Based Localization and Quantification of Bone Turnover as a Biomarker for Facet Joint-Induced Disability
  • Prospective Comparison of Changes in Lumbar Spine MRI Findings over Time between Individuals with Acute Low Back Pain and Controls: An Exploratory Study
  • Pain in elite athletes--neurophysiological, biomechanical and psychosocial considerations: a narrative review
  • Spinal manipulative therapy for low back pain
  • It is time to stop causing harm with inappropriate imaging for low back pain
  • Granulocytic sarcoma: a rare cause of sciatica
  • The diagnostic dartboard: is the bullseye a correct pathoanatomical diagnosis or to guide treatment?
  • Age- and Level-Dependence of Fatty Infiltration in Lumbar Paravertebral Muscles of Healthy Volunteers
  • Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis
  • Surgery and physical therapy likely yield similar outcomes in spinal stenosis
  • MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis
  • Recognizing and reducing cognitive bias in clinical and forensic neurology
  • Crossref (568)
  • Google Scholar

This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.

  • What low back pain is and why we need to pay attention
    Jan Hartvigsen, Mark J Hancock, Alice Kongsted, Quinette Louw, Manuela L Ferreira, Stéphane Genevay, Damian Hoy, Jaro Karppinen, Glenn Pransky, Joachim Sieper, Rob J Smeets, Martin Underwood, Rachelle Buchbinder, Jan Hartvigsen, Dan Cherkin, Nadine E Foster, Chris G Maher, Martin Underwood, Maurits van Tulder, Johannes R Anema, Roger Chou, Stephen P Cohen, Lucíola Menezes Costa, Peter Croft, Manuela Ferreira, Paulo H Ferreira, Julie M Fritz, Stéphane Genevay, Douglas P Gross, Mark J Hancock, Damian Hoy, Jaro Karppinen, Bart W Koes, Alice Kongsted, Quinette Louw, Birgitta Öberg, Wilco C Peul, Glenn Pransky, Mark Schoene, Joachim Sieper, Rob J Smeets, Judith A Turner, Anthony Woolf
    The Lancet 2018 391 10137
  • Non-specific low back pain
    Chris Maher, Martin Underwood, Rachelle Buchbinder
    The Lancet 2017 389 10070
  • Nociplastic pain: towards an understanding of prevalent pain conditions
    Mary-Ann Fitzcharles, Steven P Cohen, Daniel J Clauw, Geoffrey Littlejohn, Chie Usui, Winfried Häuser
    The Lancet 2021 397 10289
  • MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis
    W. Brinjikji, F.E. Diehn, J.G. Jarvik, C.M. Carr, D.F. Kallmes, M.H. Murad, P.H. Luetmer
    American Journal of Neuroradiology 2015 36 12
  • Low back pain
    Nebojsa Nick Knezevic, Kenneth D Candido, Johan W S Vlaeyen, Jan Van Zundert, Steven P Cohen
    The Lancet 2021 398 10294
  • The Aging of the Global Population
    Michael G. Fehlings, Lindsay Tetreault, Anick Nater, Ted Choma, James Harrop, Tom Mroz, Carlo Santaguida, Justin S. Smith
    Neurosurgery 2015 77 Supplement 1
  • Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain
    Peter B O’Sullivan, J P Caneiro, Mary O’Keeffe, Anne Smith, Wim Dankaerts, Kjartan Fersum, Kieran O’Sullivan
    Physical Therapy 2018 98 5
  • Toward a Mechanism-Based Approach to Pain Diagnosis
    Daniel Vardeh, Richard J. Mannion, Clifford J. Woolf
    The Journal of Pain 2016 17 9
  • Herniated Lumbar Intervertebral Disk
    Caren G. Solomon, Richard A. Deyo, Sohail K. Mirza
    New England Journal of Medicine 2016 374 18
  • Age- and Level-Dependence of Fatty Infiltration in Lumbar Paravertebral Muscles of Healthy Volunteers
    R.J. Crawford, L. Filli, J.M. Elliott, D. Nanz, M.A. Fischer, M. Marcon, E.J. Ulbrich
    American Journal of Neuroradiology 2016 37 4

More in this TOC Section

  • Validity of the Bern Score as a Surrogate Marker of Clinical Severity in Patients with Spontaneous Intracranial Hypotension
  • Contribution of the MP2RAGE 7T Sequence in MS Lesions of the Cervical Spinal Cord
  • Resisted Inspiration Improves Visualization of CSF-Venous Fistulas in Spontaneous Intracranial Hypotension
Show more Spine

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2022 Distinguished Reviewers

Resources

  • Evidence-Based Medicine Level Guide
  • AJNR Podcast Archive
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Get Peer Review Credit from Publons

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal

© 2023 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire