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Five-year development of lumbar disc degeneration—a prospective study

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Abstract

Objective

To examine the impact of demographic, clinical, and genetic factors as well as herniated discs on 5-year development of disc degeneration in the lumbar spine, and to investigate associations between changes in lumbar degenerative findings and pain.

Materials and methods

In 144 patients with lumbar radicular pain or low back pain, we scored disc degeneration, herniated discs, and high-intensity zones in the posterior annulus fibrosus on lumbar magnetic resonance imaging (MRI) at baseline and 5-year follow-up. Genotyping (TaqMan assay) was performed for genes encoding vitamin D receptor (VDR), collagen XIα (COL11A), matrix metalloproteinase 1/9 (MMP1/MMP9), and interleukin 1α/1RN (IL-1α/IL-1RN). Associations were analyzed using multivariate linear regression adjusted for age, sex, smoking, body mass index, and baseline scores for degenerated discs and herniated discs (when analyzing impact of baseline factors) or for pain (when analyzing associations with pain).

Results

Progression of disc degeneration over 5 years was significantly (p < 0.001) related to higher age and less disc degeneration at baseline, but not to sex, smoking, body mass index, herniated discs, or variants in the studied genes. No associations were identified between changes in disc degeneration or high-intensity zones and pain at 5-year follow-up. However, increased number of herniated discs over 5 years was associated with pain at rest (p = 0.019).

Conclusions

Age and disc degeneration at baseline, rather than genetic factors, influenced the 5-year development of disc degeneration in patients with lumbar radicular pain or low back pain. Development of herniated discs was related to pain at rest.

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Acknowledgements

Siri Bjorland is supported by the University of Oslo (Principal Research Fellowship ID: 412597). Other authors have not received financial support. The authors are grateful to the study participants.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Ulleval, Postbox 4956, Nydalen, 0424, Oslo, Norway

    Elina Iordanova Schistad, Siri Bjorland, Cecilie Røe & Kjersti Myhre

  2. Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Siri Bjorland & Cecilie Røe

  3. National Institute of Occupational Health, Oslo, Norway

    Johannes Gjerstad

  4. Department of Molecular Bioscience, University of Oslo, Oslo, Norway

    Johannes Gjerstad

  5. Department of Radiology, Haukeland University Hospital, Bergen, Norway

    Nils Vetti & Ansgar Espeland

  6. Section for Radiology, Department of Surgical Sciences, University of Bergen, Bergen, Norway

    Ansgar Espeland

Authors
  1. Elina Iordanova Schistad
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  2. Siri Bjorland
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  3. Cecilie Røe
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  4. Johannes Gjerstad
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  5. Nils Vetti
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  6. Kjersti Myhre
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  7. Ansgar Espeland
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Corresponding author

Correspondence to Elina Iordanova Schistad.

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Conflict of interest

The authors declare that they have no conflicts of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclosures

The authors declare that there are no competing interests regarding the publication of this paper.

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Schistad, E.I., Bjorland, S., Røe, C. et al. Five-year development of lumbar disc degeneration—a prospective study. Skeletal Radiol 48, 871–879 (2019). https://doi.org/10.1007/s00256-018-3062-x

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  • DOI: https://doi.org/10.1007/s00256-018-3062-x

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