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Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe : Prevalence, geographic variation and radiological correlates in men and women aged 50 and over

Armbrecht, Gabriele; Felsenberg, Dieter; Ganswindt, Melanie; Lunt, Mark; Kaptoge, Stephen K.; Abendroth, Klaus; Dias, Antonio Aroso; Bhalla, Ashok K.; Andia, Jorge Cannata and Dequeker, Jan, et al. (2017) In Rheumatology1999-01-01+01:00 56(7). p.1189-1199
Abstract

Objectives. To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results. Images from 10 132... (More)

Objectives. To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results. Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion. KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.

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keywords
Age range 50 plus years, Bone mineral density (BMD), Degenerative disease, Intervertebral disc, Kellgren-Lawrence grading, Multi-centre prevalence study, Osteochondrosis intervertebralis, Plane radiology, Population-based, Reproducibility study
in
Rheumatology1999-01-01+01:00
volume
56
issue
7
pages
11 pages
publisher
Oxford University Press
external identifiers
  • scopus:85021775415
  • wos:000404610700021
ISSN
1462-0324
DOI
10.1093/rheumatology/kex040
language
English
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yes
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8bf7e4ef-744d-42c6-bd4a-7eccef8c1381
date added to LUP
2017-08-07 15:48:42
date last changed
2018-01-07 12:14:15
@article{8bf7e4ef-744d-42c6-bd4a-7eccef8c1381,
  abstract     = {<p>Objectives. To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results. Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion. KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.</p>},
  author       = {Armbrecht, Gabriele and Felsenberg, Dieter and Ganswindt, Melanie and Lunt, Mark and Kaptoge, Stephen K. and Abendroth, Klaus and Dias, Antonio Aroso and Bhalla, Ashok K. and Andia, Jorge Cannata and Dequeker, Jan and Eastell, Richard and Hoszowski, Krzysztof and Lyritis, George and Masaryk, Pavol and van Meurs, Joyce and Miazgowski, Tomasz and Nuti, Ranuccio and Póor, Gyula and Redlund-Johnell, Inga and Reid, David M and Schatz, Helmut and Todd, Christopher J. and Woolf, Anthony D and Rivadeneira, Fernando and Javaid, Muhammad K. and Cooper, Cyrus and Silman, Alan J. and O'Neill, Terence W. and Reeve, Jonathan and Reid, D. M. and Lyritis, G. and Bhalla, A. K. and Felsenberg, D. and Banzer, D. and Reisinger, W. and Schatz, H. and Poor, G. and Todd, C. J. and Kragl, G. and Weber, K and Reeve, J. and Scheidt-Nave, C. and Abendroth, K. and Dequeker, J and Delmas, P. D. and Raspe, H. H. and Johnell, O. and O'Neill, T. W. and Benevolenskaya, L. I. and Aroso, A. and Cannata, J. and Masaryk, P. and Havelka, S. and Pols, H and Nuti, R. and Miazgowski, T. and Woolf, A. D. and Hoszowski, K. and Yershova, O. and Jajic, I. and , },
  issn         = {1462-0324},
  keyword      = {Age range 50 plus years,Bone mineral density (BMD),Degenerative disease,Intervertebral disc,Kellgren-Lawrence grading,Multi-centre prevalence study,Osteochondrosis intervertebralis,Plane radiology,Population-based,Reproducibility study},
  language     = {eng},
  month        = {07},
  number       = {7},
  pages        = {1189--1199},
  publisher    = {Oxford University Press},
  series       = {Rheumatology1999-01-01+01:00},
  title        = {Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe : Prevalence, geographic variation and radiological correlates in men and women aged 50 and over},
  url          = {http://dx.doi.org/10.1093/rheumatology/kex040},
  volume       = {56},
  year         = {2017},
}