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Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association

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Abstract

Summary

A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese.

Purpose

Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese.

Methods

We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis.

Results

Greater facet joint osteoarthritis was associated with greater spine BMD (P < 0.01) in both patients and general subjects. For general subjects, greater spine BMD was associated with severe disc degeneration, controlling for age, gender, BMI, and lumbar region. When facet joint osteoarthritis entered the regression model, however, greater spine BMD was associated with greater facet joint osteoarthritis (P < 0.01) but not greater disc degeneration (P > 0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05).

Conclusion

BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

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Acknowledgements

This study was supported by the Health and Family Planning Commission of Zhejiang Province (2013KYB103, 201338397) and National Natural Science Foundation of China (NSFC 81371995). We thank Ms. Ying Yuan for her support in data collection.

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Authors and Affiliations

  1. Spine lab, Department of Orthopedic Surgery, The First Affiliated Hospital of Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China

    Jianjiang Pan, Xuan Lu, Ge Yang, Xiang Tong & Yue Wang

  2. Healthcare center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310020, China

    Yongmei Han

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  1. Jianjiang Pan
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  3. Ge Yang
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Correspondence to Yue Wang.

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Pan, J., Lu, X., Yang, G. et al. Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association. Arch Osteoporos 12, 20 (2017). https://doi.org/10.1007/s11657-017-0315-6

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