Degenerative Disc Disease: How Early Does It occur? An MRI Study of 154 Ten Year Old Children

Abstract

HTML Purpose: One hundred and fifty four children (seventy-nine female and seventy-five male), in their eleventh year of life, taking part in a larger study to assess spinal canal dimensions, had MRI examination of the lumbar spine. The observation that some of these children showed loss of signal from the nucleus of one or more intervertebral discs prompted us to review all the studies. Methods and Materials: One hundred and fifty four children (seventy-nine female and seventy-five male), in their eleventh year of life, taking part in a larger study were studied. None of them had ever suffered from low back pain or leg pain. Observations of the status of the intervertebral discs were made from a series of seven sagittal, T2 weighted MRI images, by two trained observers. Results: Of the 154 children, 140 of them were found to have normal intervertebral discs. The appearances of the nuclei of these normal discs were found to fall into three distinct types. 111 had the characteristic oval shape with central cleft, 7 had small round nuclei and 22 had nuclei that were club shaped. There was an equal distribution of the three types between the two sexes. 14 of the children showed one abnormal disc at either the L4/5 or L5/S1 levels. 4 of them (2 males, 2 females) showed a loss of signal from the nucleus consistent with degeneration of the nucleus. The other 10 (6 males, 4 females) showed not only loss of signal from the nucleus but also posterior protrusion of the nucleus, with early posterior annular bulging. Conclusion: These observations would suggest that assymptomatic, degenerative changes in the intervertebral discs can occur early in life, before puberty.