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Relationship between gender, bone mineral density, and disc degeneration in the lumbar spine: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system

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Abstract

Summary

The study cohort comprised 196 females and 163 males. Lumbar spine bone mineral density (BMD) and magnetic resonance imaging (MRI) were acquired. Females had more severe disc degeneration than males. Lumbar spine lower BMD was associated with less severe disc degeneration. Lumbar disc spaces were more likely to be narrower when vertebral BMD was higher.

Introduction

The purpose of this paper is to study the relationship between gender, BMD, and disc degeneration in the lumbar spine.

Methods

The study cohort comprised 196 females and 163 males (age range 67–89 years) with no age difference between the two groups. Lumbar spine BMD was measured with dual X-ray densitometry, and MRI was acquired at 1.5 T. A subgroup of 48 males had additional lumbar vertebral quantitative computerized tomography densitometry. Lumbar disc degeneration was assessed using a MRI-based eight-level grading system.

Results

Female subjects had more severe disc degeneration than male subjects. After removing age effect, a positive trend was observed between T-score and severity of lumbar disc degeneration. This was significant in female subjects while not significant in male subjects. Lumbar disc spaces were more likely to be narrowed when vertebral BMD was higher. These observations were more significant in the midlumbar region (L3/4 and L4/5) and less so at the thoracolumbar junction.

Conclusion

Female subjects tended to have slightly more severe lumbar disc degeneration than male subjects. Lower lumbar spine BMD was associated with less severe disc degeneration.

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References

  1. Andersson GB (1999) Epidemiological features of chronic low-back pain. Lancet 354:581–585

    Article  CAS  PubMed  Google Scholar 

  2. Foss VL, Byers PD (1972) Bone density, osteoarthrosis of the hip, and fracture of the upper end of the femur. Ann Rheum Dis 31:259–264

    Article  CAS  PubMed  Google Scholar 

  3. Harada A, Okuizumi H, Miyagi N, Genda E (1998) Correlation between bone mineral density and intervertebral disc degeneration. Spine 23:857–861

    Article  CAS  PubMed  Google Scholar 

  4. Dequeker J, Aerssens J, Luyten FP (2003) Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res 15:426–439

    PubMed  Google Scholar 

  5. Miyakoshi N, Itoi E, Murai H, Wakabayashi I, Ito H, Minato T (2003) Inverse relation between osteoporosis and spondylosis in postmenopausal women as evaluated by bone mineral density and semiquantitative scoring of spinal degeneration. Spine 28:492–495

    Article  PubMed  Google Scholar 

  6. Weintroub S, Papo J, Ashkenazi M, Tardiman R, Weissman SL, Salama R (1982) Osteoarthritis of hip and fractures of the proximal end of the femur. Acta Orthop Scand 53:261–264

    Article  CAS  PubMed  Google Scholar 

  7. Marcelli C, Favier F, Kotzki PO, Ferrazzi V, Picot MC, Simon L (1995) The relationship between osteoarthritis of the hands, bone mineral density, and osteoporotic fractures in elderly women. Osteoporos Int 5:382–388

    Article  CAS  PubMed  Google Scholar 

  8. Verstraeten A, Van Ermen H, Haghebaert G, Nijs J, Geusens P, Dequeker J (1991) Osteoarthrosis retards the development of osteoporosis: observation of the coexistence of Osteoarthrosis and osteoporosis. Clin Orthop 264:169–177

    PubMed  Google Scholar 

  9. Margulies JY, Payzer A, Nyska M, Neuwirth MG, Floman Y, Robin GC (1996) The relationship between degenerative changes and osteoporosis in the lumbar spine. Clin Orthop 324:145–152

    Article  PubMed  Google Scholar 

  10. Wang T, Zhang L, Huang C, Cheng AG, Dang GT (2004) Relationship between osteopenia and lumbar intervertebral disc degeneration in ovariectomized rats. Calcif Tissue Int 75:205–213

    Article  CAS  PubMed  Google Scholar 

  11. Pye SR, Reid DM, Adams JE, Silman AJ, O'Neill TW (2006) Radiographic features of lumbar disc degeneration and bone mineral density in men and women. Ann Rheum Dis 65:234–238

    Article  CAS  PubMed  Google Scholar 

  12. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878

    Article  CAS  PubMed  Google Scholar 

  13. Griffith JF, Wang YX, Antonio GE, Choi KC, Yu A, Ahuja AT, Leung PC (2007) Modified Pfirrmann grading system for lumbar intervertebral disc degeneration in elderly subjects. Spine 32:E708–E712

    Article  PubMed  Google Scholar 

  14. Assessment of risk fracture and its application to screening for postmenopausal osteoporosis: report of a WHO study group. World Health Organ Tech Rep Ser 843:1–129

  15. Lynn HS, Lau EM, Au B, Leung PC (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporos Int 16:1663–1668

    Article  CAS  PubMed  Google Scholar 

  16. Rehman Q, Lang T, Modin G, Lane NEQ (2002) Quantitative computed tomography of the lumbar spine, not dual x-ray absorptiometry, is an independent predictor of prevalent vertebral fractures in postmenopausal women with osteopenia receiving long-term glucocorticoid and hormone-replacement therapy. Arthritis Rheum 46:1292–1297

    Article  CAS  PubMed  Google Scholar 

  17. Manson NA, Goldberg EJ (2006) Andersson GB (2006) Sexual dimorphism in degenerative disorders of the spine. Orthop Clin North Am 37:549–553

    Article  PubMed  Google Scholar 

  18. Baron YM, Brincat MP, Galea R, Calleja N (2005) Intervertebral disc height in treated and untreated overweight post-menopausal women. Hum Reprod 20:3566–3570

    Article  PubMed  Google Scholar 

  19. Kellgren JH, Lawrence JS (1958) Osteoarthrosis and disc degeneration in an urban population. Ann Rheum Dis 17:388–396

    Article  CAS  PubMed  Google Scholar 

  20. Masud T, Langley S, Wiltshire P, Doyle DV, Spector TD (1993) Effect of spinal osteophytosis on bone mineral density measurements in vertebral osteoporosis. Br Med J 307:172–173

    Article  CAS  Google Scholar 

  21. Oxland TR, Lund T, Jost B, Cripton P, Lippuner K, Jaeger P, Nolte LP (1996) The relative importance of vertebral bone density and disc degeneration in spinal flexibility and interbody in implant performance. An in vitro study. Spine 21:2558–2569

    Article  CAS  PubMed  Google Scholar 

  22. Muraki S, Yamamoto S, Ishibashi H, Horiuchi T, Hosoi T, Orimo H, Nakamura K (2004) Impact of degenerative spinal diseases on bone mineral density of the lumbar spine in elderly women. Osteoporos Int 15:724–728

    Article  PubMed  Google Scholar 

  23. Kwok AW, Griffith JF, Ma HT, Wang Y, Leung PC, Leung J, Yeung DK (2008) Estimated volume of both vertebral body and disc decreases as BMD decreases though this effect is seen more in the vertebral body than the disc. Bone 43(suppl 1):S66–S66

    Article  Google Scholar 

  24. Ritzel H, Amling M, Pösl M, Hahn M, Delling G (1997) The thickness of human vertebral cortical bone and its changes in aging and osteoporosis: a histomorphometric analysis of the complete spinal column from thirty-seven autopsy specimens. J Bone Miner Res 12:89–95

    Article  CAS  PubMed  Google Scholar 

  25. Langrana NA, Kale SP, Edwards WT, Lee CK, Kopacz KJ (2006) Measurement and analyses of the effects of adjacent end plate curvatures on vertebral stresses. Spine J 6:267–278

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, People’s Republic of China

    Y.-X. J. Wang, J. F. Griffith, D. K. W. Yeung & A. T. Ahuja

  2. Jockey Club Centre for Osteoporosis Care and Control, School of Public Health, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, People’s Republic of China

    H. T. Ma, A. W. L. Kwok, J. C. S. Leung & P. C. Leung

Authors
  1. Y.-X. J. Wang
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  2. J. F. Griffith
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  3. H. T. Ma
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  4. A. W. L. Kwok
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  5. J. C. S. Leung
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  6. D. K. W. Yeung
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  7. A. T. Ahuja
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  8. P. C. Leung
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Correspondence to Y.-X. J. Wang.

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Wang, YX.J., Griffith, J.F., Ma, H.T. et al. Relationship between gender, bone mineral density, and disc degeneration in the lumbar spine: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system. Osteoporos Int 22, 91–96 (2011). https://doi.org/10.1007/s00198-010-1200-y

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  • DOI: https://doi.org/10.1007/s00198-010-1200-y

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