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Research ArticleSpine Imaging and Spine Image-Guided Interventions
Open Access

Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations

W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes and J.G. Jarvik
American Journal of Neuroradiology April 2015, 36 (4) 811-816; DOI: https://doi.org/10.3174/ajnr.A4173
W. Brinjikji
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
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P.H. Luetmer
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
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B. Comstock
bDepartments of Biostatistics (B.C.)
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
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B.W. Bresnahan
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
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L.E. Chen
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
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R.A. Deyo
fDepartments of Family Medicine, Medicine, and Public Health and Preventive Medicine and the Oregon Institute of Occupational Health Sciences (R.A.D.), Oregon Health and Science University, Portland, Oregon
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S. Halabi
gDepartment of Radiology (S.H.), Henry Ford Hospital, Detroit, Michigan
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J.A. Turner
dPsychiatry and Behavioral Sciences (J.A.T.)
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A.L. Avins
hDepartment of Radiology (A.L.A.), University of California, San Francisco, San Francisco, California
iDivision of Research (A.L.A.), Kaiser Permanente, Northern California, Oakland, California.
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K. James
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
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J.T. Wald
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
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D.F. Kallmes
aFrom the Department of Radiology (W.B., P.H.L., J.T.W., D.F.K.), Mayo Clinic, Rochester, Minnesota
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J.G. Jarvik
cRadiology (B.C., B.W.B., L.E.C., K.J., J.G.J.)
eNeurological Surgery and Health Services (J.G.J.), Comparative Effectiveness Cost and Outcomes Research Center, University of Washington, Seattle, Washington
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    Results of literature search.

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    Table 1:

    Estimated number of patients by age used to inform prevalence of degenerative spine imaging findings in asymptomatic patientsa

    Imaging FindingAge (yr)
    20304050607080
    Disk degeneration273 (9)604 (16)415 (12)311 (10)80 (4)20 (2)19 (2)
    Disk signal loss46 (2)142 (5)352 (4)73 (2)35 (1)15 (1)14 (1)
    Disk height loss15 (1)163 (5)186 (5)208 (5)35 (1)15 (1)14 (1)
    Disk bulge55 (4)101 (7)151 (8)123 (7)66 (5)24 (3)22 (3)
    Disk protrusion87 (5)468 (14)490 (14)363 (12)86 (5)19 (2)17 (2)
    Annular fissure167 (5)350 (5)426 (7)53 (3)35 (3)15 (1)14 (1)
    Facet degeneration0 (0)0 (0)596 (3)53 (3)35 (3)15 (1)14 (1)
    Spondylolisthesis0 (0)0 (0)31 (1)53 (1)35 (1)15 (1)14 (1)
    • ↵a The number of studies are in parentheses.

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    Table 2:

    Age-specific prevalence estimates of degenerative spine imaging findings in asymptomatic patientsa

    Imaging FindingAge (yr)
    20304050607080
    Disk degeneration37%52%68%80%88%93%96%
    Disk signal loss17%33%54%73%86%94%97%
    Disk height loss24%34%45%56%67%76%84%
    Disk bulge30%40%50%60%69%77%84%
    Disk protrusion29%31%33%36%38%40%43%
    Annular fissure19%20%22%23%25%27%29%
    Facet degeneration4%9%18%32%50%69%83%
    Spondylolisthesis3%5%8%14%23%35%50%
    • ↵a Prevalence rates estimated with a generalized linear mixed-effects model for the age-specific prevalence estimate (binomial outcome) clustering on study and adjusting for the midpoint of each reported age interval of the study.

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American Journal of Neuroradiology: 36 (4)
American Journal of Neuroradiology
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1 Apr 2015
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W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes, J.G. Jarvik
Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
American Journal of Neuroradiology Apr 2015, 36 (4) 811-816; DOI: 10.3174/ajnr.A4173

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Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes, J.G. Jarvik
American Journal of Neuroradiology Apr 2015, 36 (4) 811-816; DOI: 10.3174/ajnr.A4173
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