Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers the Impact of Cervical Alignment on Disk Degeneration

Eijiro Okada, Kenshi Daimon, Hirokazu Fujiwara, Yuji Nishiwaki, 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

Abstract

Study Design: A 20-year longitudinal study. Objective: To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. Summary of Background Data: This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. Materials and Methods: We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18.1%). The mean age at the initial study was 35.5 13.4 years (11-65 y). We compared initial MRIs and follow-up MRIs, conducted at an average of 21.6 years after the initial study, for (1) decreased signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk-space narrowing from C2-3 to C7-T1. Subjects were grouped by age at follow-up (under 40 vs. 40 y and older) and by a lordotic or nonlordotic cervical sagittal alignment at baseline. We assessed neck pain, stiff shoulders, and upper-arm numbness at follow-up, and examined associations between clinical symptoms and MRI parameters. Results: Progressive changes during the 20-year period included a decrease in disk signal intensity (84.4% of subjects), posterior disk protrusion (86.7%), and disk-space narrowing (17.8%). No significant association was observed between sagittal alignment and decreased disk signal intensity, posterior disk protrusion, or disk-space narrowing. Among subjects over the age of 40, progressive degenerative changes at C7-T1 were significantly more frequent in nonlordotic subjects (90.9%) compared with those with cervical lordosis (54.2%, P= 0.032). The prevalence of clinical symptoms was similar in lordotic and nonlordotic subjects at follow-up. Conclusions: Nonlordotic cervical alignment was related to the progression of disk degeneration at C7-T1 but not other levels. Cervical alignment did not affect the development of clinical symptoms in healthy subjects.

Original languageEnglish
Pages (from-to)446-451
Number of pages6
JournalClinical Spine Surgery
Volume31
Issue number10
DOIs
Publication statusPublished - 01-12-2018
Externally publishedYes

Fingerprint

Intervertebral Disc Degeneration
Volunteers
Healthy Volunteers
Magnetic Resonance Imaging
Longitudinal Studies
Spine
Lordosis
Hypesthesia
Neck Pain
Intervertebral Disc
Arm

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Okada, Eijiro ; Daimon, Kenshi ; Fujiwara, Hirokazu ; Nishiwaki, Yuji ; Nojiri, Kenya ; Watanabe, Masahiko ; Katoh, Hiroyuki ; Shimizu, Kentaro ; Ishihama, Hiroko ; Fujita, Nobuyuki ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers the Impact of Cervical Alignment on Disk Degeneration. In: Clinical Spine Surgery. 2018 ; Vol. 31, No. 10. pp. 446-451.
@article{efc2641ebd314b19b308d5d68301ee42,
title = "Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers the Impact of Cervical Alignment on Disk Degeneration",
abstract = "Study Design: A 20-year longitudinal study. Objective: To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. Summary of Background Data: This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. Materials and Methods: We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18.1{\%}). The mean age at the initial study was 35.5 13.4 years (11-65 y). We compared initial MRIs and follow-up MRIs, conducted at an average of 21.6 years after the initial study, for (1) decreased signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk-space narrowing from C2-3 to C7-T1. Subjects were grouped by age at follow-up (under 40 vs. 40 y and older) and by a lordotic or nonlordotic cervical sagittal alignment at baseline. We assessed neck pain, stiff shoulders, and upper-arm numbness at follow-up, and examined associations between clinical symptoms and MRI parameters. Results: Progressive changes during the 20-year period included a decrease in disk signal intensity (84.4{\%} of subjects), posterior disk protrusion (86.7{\%}), and disk-space narrowing (17.8{\%}). No significant association was observed between sagittal alignment and decreased disk signal intensity, posterior disk protrusion, or disk-space narrowing. Among subjects over the age of 40, progressive degenerative changes at C7-T1 were significantly more frequent in nonlordotic subjects (90.9{\%}) compared with those with cervical lordosis (54.2{\%}, P= 0.032). The prevalence of clinical symptoms was similar in lordotic and nonlordotic subjects at follow-up. Conclusions: Nonlordotic cervical alignment was related to the progression of disk degeneration at C7-T1 but not other levels. Cervical alignment did not affect the development of clinical symptoms in healthy subjects.",
author = "Eijiro Okada and Kenshi Daimon and Hirokazu Fujiwara and Yuji Nishiwaki 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",
year = "2018",
month = "12",
day = "1",
doi = "10.1097/BSD.0000000000000706",
language = "English",
volume = "31",
pages = "446--451",
journal = "Clinical Spine Surgery",
issn = "2380-0186",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

Okada, E, Daimon, K, Fujiwara, H, Nishiwaki, Y, Nojiri, K, Watanabe, M, Katoh, H, Shimizu, K, Ishihama, H, Fujita, N, Tsuji, T, Nakamura, M, Matsumoto, M & Watanabe, K 2018, 'Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers the Impact of Cervical Alignment on Disk Degeneration', Clinical Spine Surgery, vol. 31, no. 10, pp. 446-451. https://doi.org/10.1097/BSD.0000000000000706

Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers the Impact of Cervical Alignment on Disk Degeneration. / Okada, Eijiro; Daimon, Kenshi; Fujiwara, Hirokazu; Nishiwaki, Yuji; Nojiri, Kenya; Watanabe, Masahiko; Katoh, Hiroyuki; Shimizu, Kentaro; Ishihama, Hiroko; Fujita, Nobuyuki; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

In: Clinical Spine Surgery, Vol. 31, No. 10, 01.12.2018, p. 446-451.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers the Impact of Cervical Alignment on Disk Degeneration

AU - Okada, Eijiro

AU - Daimon, Kenshi

AU - Fujiwara, Hirokazu

AU - Nishiwaki, Yuji

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 - 2018/12/1

Y1 - 2018/12/1

N2 - Study Design: A 20-year longitudinal study. Objective: To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. Summary of Background Data: This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. Materials and Methods: We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18.1%). The mean age at the initial study was 35.5 13.4 years (11-65 y). We compared initial MRIs and follow-up MRIs, conducted at an average of 21.6 years after the initial study, for (1) decreased signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk-space narrowing from C2-3 to C7-T1. Subjects were grouped by age at follow-up (under 40 vs. 40 y and older) and by a lordotic or nonlordotic cervical sagittal alignment at baseline. We assessed neck pain, stiff shoulders, and upper-arm numbness at follow-up, and examined associations between clinical symptoms and MRI parameters. Results: Progressive changes during the 20-year period included a decrease in disk signal intensity (84.4% of subjects), posterior disk protrusion (86.7%), and disk-space narrowing (17.8%). No significant association was observed between sagittal alignment and decreased disk signal intensity, posterior disk protrusion, or disk-space narrowing. Among subjects over the age of 40, progressive degenerative changes at C7-T1 were significantly more frequent in nonlordotic subjects (90.9%) compared with those with cervical lordosis (54.2%, P= 0.032). The prevalence of clinical symptoms was similar in lordotic and nonlordotic subjects at follow-up. Conclusions: Nonlordotic cervical alignment was related to the progression of disk degeneration at C7-T1 but not other levels. Cervical alignment did not affect the development of clinical symptoms in healthy subjects.

AB - Study Design: A 20-year longitudinal study. Objective: To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. Summary of Background Data: This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. Materials and Methods: We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18.1%). The mean age at the initial study was 35.5 13.4 years (11-65 y). We compared initial MRIs and follow-up MRIs, conducted at an average of 21.6 years after the initial study, for (1) decreased signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk-space narrowing from C2-3 to C7-T1. Subjects were grouped by age at follow-up (under 40 vs. 40 y and older) and by a lordotic or nonlordotic cervical sagittal alignment at baseline. We assessed neck pain, stiff shoulders, and upper-arm numbness at follow-up, and examined associations between clinical symptoms and MRI parameters. Results: Progressive changes during the 20-year period included a decrease in disk signal intensity (84.4% of subjects), posterior disk protrusion (86.7%), and disk-space narrowing (17.8%). No significant association was observed between sagittal alignment and decreased disk signal intensity, posterior disk protrusion, or disk-space narrowing. Among subjects over the age of 40, progressive degenerative changes at C7-T1 were significantly more frequent in nonlordotic subjects (90.9%) compared with those with cervical lordosis (54.2%, P= 0.032). The prevalence of clinical symptoms was similar in lordotic and nonlordotic subjects at follow-up. Conclusions: Nonlordotic cervical alignment was related to the progression of disk degeneration at C7-T1 but not other levels. Cervical alignment did not affect the development of clinical symptoms in healthy subjects.

UR - http://www.scopus.com/inward/record.url?scp=85052832401&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052832401&partnerID=8YFLogxK

U2 - 10.1097/BSD.0000000000000706

DO - 10.1097/BSD.0000000000000706

M3 - Article

C2 - 30102637

AN - SCOPUS:85052832401

VL - 31

SP - 446

EP - 451

JO - Clinical Spine Surgery

JF - Clinical Spine Surgery

SN - 2380-0186

IS - 10

ER -