A 20-year prospective longitudinal study of degeneration of the cervical spine in a volunteer cohort assessed using MRI follow-up of a cross-sectional study

Kenshi Daimon, Hirokazu Fujiwara, Yuji Nishiwaki, Eijiro Okada, Kenya Nojiri, Masahiko Watanabe, Hiroyuki Katoh, Kentaro Shimizu, Hiroko Ishihama, Nobuyuki Fujita, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe

Research output: Contribution to journalArticle

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Abstract

Background: Few studies have addressed in detail long-term degenerative changes in the cervical spine. In this study, we evaluated the progression of degenerative changes of the cervical spine that occurred over a 20-year period in an originally healthy cohort. We also sought to clarify the relationship between the progression of cervical degenerative changes and the development of clinical symptoms. Methods: For this prospective follow-up investigation, we recruited 193 subjects from an original cohort of 497 participants who had undergone magnetic resonance imaging (MRI) of the cervical spine between 1993 and 1996. The subjects were asked about the presence or absence of cervical spine-related symptoms. Degenerative changes of the cervical spine were assessed on MRI using an original numerical grading system. The relationship between the progression of degenerative changes and the onset of clinical symptoms was evaluated by logistic regression analysis. Results: Degeneration in the cervical spine was found to have progressed in 95% of the subjects during the 20-year period. The finding of a decrease in signal intensity of the intervertebral disc progressed in a relatively high proportion of the subjects in all age groups and occurred with similar frequency (around 60%) at all intervertebral disc levels. The rate of progression of other structural failures on MRI increased with age and was highest at C5-C6. The progression of foraminal stenosis was associated with the onset of upper-limb pain (odds ratio, 4.71 [95% confidence interval, 1.02 to 21.7]). Conclusions: A progression of degenerative changes in the cervical spine on MRI over the 20-year period was detected in nearly all subjects. There was no relationship between the progression of degeneration on MRI and the development of clinical symptoms, with the exception of an association found between foraminal stenosis and upper-limb pain. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)843-849
Number of pages7
JournalJournal of Bone and Joint Surgery - American Volume
Volume100
Issue number10
DOIs
Publication statusPublished - 01-01-2018

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Longitudinal Studies
Volunteers
Spine
Cross-Sectional Studies
Magnetic Resonance Imaging
Prospective Studies
Intervertebral Disc
Upper Extremity
Pathologic Constriction
Pain
Age Groups
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Daimon, Kenshi ; Fujiwara, Hirokazu ; Nishiwaki, Yuji ; Okada, Eijiro ; Nojiri, Kenya ; Watanabe, Masahiko ; Katoh, Hiroyuki ; Shimizu, Kentaro ; Ishihama, Hiroko ; Fujita, Nobuyuki ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / A 20-year prospective longitudinal study of degeneration of the cervical spine in a volunteer cohort assessed using MRI follow-up of a cross-sectional study. In: Journal of Bone and Joint Surgery - American Volume. 2018 ; Vol. 100, No. 10. pp. 843-849.
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author = "Kenshi Daimon and Hirokazu Fujiwara and Yuji Nishiwaki and Eijiro Okada and Kenya Nojiri and Masahiko Watanabe and Hiroyuki Katoh and Kentaro Shimizu and Hiroko Ishihama and Nobuyuki Fujita and Takashi Tsuji and Masaya Nakamura and Morio Matsumoto and Kota Watanabe",
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Daimon, K, Fujiwara, H, Nishiwaki, Y, Okada, E, Nojiri, K, Watanabe, M, Katoh, H, Shimizu, K, Ishihama, H, Fujita, N, Tsuji, T, Nakamura, M, Matsumoto, M & Watanabe, K 2018, 'A 20-year prospective longitudinal study of degeneration of the cervical spine in a volunteer cohort assessed using MRI follow-up of a cross-sectional study' Journal of Bone and Joint Surgery - American Volume, vol. 100, no. 10, pp. 843-849. https://doi.org/10.2106/JBJS.17.01347

A 20-year prospective longitudinal study of degeneration of the cervical spine in a volunteer cohort assessed using MRI follow-up of a cross-sectional study. / Daimon, Kenshi; Fujiwara, Hirokazu; Nishiwaki, Yuji; Okada, Eijiro; Nojiri, Kenya; Watanabe, Masahiko; Katoh, Hiroyuki; Shimizu, Kentaro; Ishihama, Hiroko; Fujita, Nobuyuki; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

In: Journal of Bone and Joint Surgery - American Volume, Vol. 100, No. 10, 01.01.2018, p. 843-849.

Research output: Contribution to journalArticle

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T1 - A 20-year prospective longitudinal study of degeneration of the cervical spine in a volunteer cohort assessed using MRI follow-up of a cross-sectional study

AU - Daimon, Kenshi

AU - Fujiwara, Hirokazu

AU - Nishiwaki, Yuji

AU - Okada, Eijiro

AU - Nojiri, Kenya

AU - Watanabe, Masahiko

AU - Katoh, Hiroyuki

AU - Shimizu, Kentaro

AU - Ishihama, Hiroko

AU - Fujita, Nobuyuki

AU - Tsuji, Takashi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Kota

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Few studies have addressed in detail long-term degenerative changes in the cervical spine. In this study, we evaluated the progression of degenerative changes of the cervical spine that occurred over a 20-year period in an originally healthy cohort. We also sought to clarify the relationship between the progression of cervical degenerative changes and the development of clinical symptoms. Methods: For this prospective follow-up investigation, we recruited 193 subjects from an original cohort of 497 participants who had undergone magnetic resonance imaging (MRI) of the cervical spine between 1993 and 1996. The subjects were asked about the presence or absence of cervical spine-related symptoms. Degenerative changes of the cervical spine were assessed on MRI using an original numerical grading system. The relationship between the progression of degenerative changes and the onset of clinical symptoms was evaluated by logistic regression analysis. Results: Degeneration in the cervical spine was found to have progressed in 95% of the subjects during the 20-year period. The finding of a decrease in signal intensity of the intervertebral disc progressed in a relatively high proportion of the subjects in all age groups and occurred with similar frequency (around 60%) at all intervertebral disc levels. The rate of progression of other structural failures on MRI increased with age and was highest at C5-C6. The progression of foraminal stenosis was associated with the onset of upper-limb pain (odds ratio, 4.71 [95% confidence interval, 1.02 to 21.7]). Conclusions: A progression of degenerative changes in the cervical spine on MRI over the 20-year period was detected in nearly all subjects. There was no relationship between the progression of degeneration on MRI and the development of clinical symptoms, with the exception of an association found between foraminal stenosis and upper-limb pain. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

AB - Background: Few studies have addressed in detail long-term degenerative changes in the cervical spine. In this study, we evaluated the progression of degenerative changes of the cervical spine that occurred over a 20-year period in an originally healthy cohort. We also sought to clarify the relationship between the progression of cervical degenerative changes and the development of clinical symptoms. Methods: For this prospective follow-up investigation, we recruited 193 subjects from an original cohort of 497 participants who had undergone magnetic resonance imaging (MRI) of the cervical spine between 1993 and 1996. The subjects were asked about the presence or absence of cervical spine-related symptoms. Degenerative changes of the cervical spine were assessed on MRI using an original numerical grading system. The relationship between the progression of degenerative changes and the onset of clinical symptoms was evaluated by logistic regression analysis. Results: Degeneration in the cervical spine was found to have progressed in 95% of the subjects during the 20-year period. The finding of a decrease in signal intensity of the intervertebral disc progressed in a relatively high proportion of the subjects in all age groups and occurred with similar frequency (around 60%) at all intervertebral disc levels. The rate of progression of other structural failures on MRI increased with age and was highest at C5-C6. The progression of foraminal stenosis was associated with the onset of upper-limb pain (odds ratio, 4.71 [95% confidence interval, 1.02 to 21.7]). Conclusions: A progression of degenerative changes in the cervical spine on MRI over the 20-year period was detected in nearly all subjects. There was no relationship between the progression of degeneration on MRI and the development of clinical symptoms, with the exception of an association found between foraminal stenosis and upper-limb pain. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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