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Aging of the Cervical Spine in Healthy Volunteers: A 10-Year Longitudinal Magnetic Resonance Imaging Study

Okada, Eijiro MD*; Matsumoto, Morio MD; Ichihara, Daisuke MD*; Chiba, Kazuhiro MD*; Toyama, Yoshiaki MD*; Fujiwara, Hirokazu MD; Momoshima, Suketaka MD; Nishiwaki, Yuji MD§; Hashimoto, Takeshi MD; Ogawa, Jun MD; Watanabe, Masahiko MD**; Takahata, Takeshi MD††

doi: 10.1097/BRS.0b013e31819c2003
Diagnostics

Study Design. Prospective longitudinal study, mean follow-up period; 11.7 ± 0.8 years was conducted from 1995 to 2007.

Objective. To clarify normal aging process of cervical spine and correlation between progression of disc degeneration and development of clinical symptoms.

Summary of Background Data. Aging of the cervical spine can inevitably occur in anyone. Long-term longitudinal studies following the same individuals are necessary to elucidate the accurate aging processes of the cervical spine.

Methods. Two hundred twenty-three subjects of 497 original cohorts (123 men, 100 women, mean age: 39.0 ± 15.0, follow-up rate: 44.9%). Subjects, who underwent MRI 10 years ago, underwent another MRI, neurologic examination, and questionnaire survey regarding symptoms related to cervical spine and life style. Following 5 MR findings representing intervertebral disc degeneration were evaluated: (1) decrease in signal intensity of disc, (2) anterior compression of dura and spinal cord, (3) posterior disc protrusion (PDP), (4) disc space narrowing (DSN), and (5) foraminal stenosis (FS).

Results. Progression of degenerative findings was observed in 189 subjects (81.1%). Progression of decrease in signal intensity of disc was observed in 59.6%, anterior compression of dura and spinal cord in 61.4%, PDP in 70.0%, DSN in 26.9%, and FS in 9.0%. Logistic regression analysis revealed that incidence of progression of PDP, DSN, FS was higher in elderly subjects. There were no correlations between any degenerative MR findings and sex, smoking, alcohol, sport, or body mass index. Neck pain, shoulder stiffness, and numbness in upper extremities were recognized in 9.9%, 30.0%, and 4.0% of subjects, and 1 or more clinical symptoms have developed in 34.1% during 10 years.

Conclusion. Progression of degeneration of cervical spine on MRI was frequently observed during 10-year period, with development of symptoms in 34% of subjects. No factor related to progression of degeneration of cervical spine was identified except for age.

To clarify normal aging process of cervical spine, prospective 10-year longitudinal MRI study was conducted. Progression of degeneration of cervical spine on MRI was frequently observed during 10-year period, with development of symptoms in 34% of subjects. No factor related to progression of degeneration of cervical spine was identified except for age.

From the Departments of *Orthopaedic Surgery, Advanced Therapy for Spine and Spinal Cord Diseases, ‡Diagnostic Radiology, §Preventive Medicine and Public Health, Keio University, Tokyo, Japan; ¶Department of Orthopaedic Surgery, Tsukigase Rehabilitation Center, Keio University, Tokyo, Japan; ∥Department of Orthopaedic Surgery, Kyorin University, Mitaka, Tokyo; **Department of Orthopaedic Surgery, Tokai University, Isehara, Kanagawa; and ††Department of Orthopaedic Surgery, Isehara Kyodo Hospital, Isehara, Japan.

Acknowledgment date: September 2, 2008. Revision date: October 12, 2008. Acceptance date: October 20, 2008.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Other funds were received in support of this work. One or more of the author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript: e.g., honoraria, gifts, consultancies.

This work was supported by the General Insurance Association of Japan.

Conflict of Interest Disclosures Morio Matsumoto has consultant fee from Medtronic Japan and Kyoei Fire and Marine Insurance and has received honorarium from the General Insurance Association of Japan for workshop. Kazuhiro Chiba has received honorarium from the General Insurance Association of Japan for workshop. The other authors have no conflict of interest. The authors obtained approvals from the Ethics Committees of all participating institutions. A written informed consent from the participants was obtained after the oral explanations on the details of the present study.

Address correspondence and reprint requests to Morio Matsumoto, MD, Department of Advanced Therapy for Spine and Spinal Cord Diseases, Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; E-mail: morio@sc.itc.keio.ac.jp

© 2009 Lippincott Williams & Wilkins, Inc.