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Prevalence of Concurrent Lumbar and Cervical Arthrosis: An Anatomic Study of Cadaveric Specimens

Master, Daniel L., MD; Eubanks, Jason D., MD; Ahn, Nicholas U., MD

doi: 10.1097/BRS.0b013e318195d10b

Study Design. An anatomic, epidemiologic study of lumbar and cervical arthrosis in cadaveric spines.

Objective. Determine the prevalence of combined lumbar and cervical arthrosis in a large population sample and examine its association with age, sex, and race.

Summary of Background Data. Lumbar and cervical arthrosis are common radiographic findings, which have both been linked to pain. However, the prevalence of and temporal relationship between combined lumbar and cervical arthrosis has not been defined.

Methods. The lumbar and cervical segments from 234 cadaveric spines were examined by a single investigator for evidence of endplate and facet arthrosis. Arthrosis at each endplate and facet was graded on a continuum from 0 to IV. Race, age at death, and sex of each specimen was recorded.

Stepwise multiple linear regression was used to analyze any association between race, age, sex, lumbar arthrosis, and cervical arthrosis. Factors with P-values <0.05 remained in the analysis. T tests for matched samples were used to analyze any difference between the mean lumbar and cervical arthrosis severity among patients within the same decades of life.

Results. Concurrent lumbar and cervical arthrosis was present in 80% of the study population. Stepwise multiple linear regression revealed significant (P < 0.01) associations between lumbar arthrosis and cervical arthrosis and between age and cervical arthrosis. Race and sex did not correlate with lumbar or cervical arthrosis. In addition, patients in age groups 20 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and 80 to 89 demonstrated more severe (P < 0.01) lumbar arthrosis in comparison to cervical arthrosis.

Conclusion. Concurrent lumbar and cervical arthrosis is a common condition. Lumbar arthrosis and advancing age are associated with cervical arthrosis independent of race and sex. Lumbar arthrosis precedes cervical arthrosis. These findings suggest an underlying systemic component for spinal osteoarthritis.

The lumbar and cervical segments from 234 cadaveric spines were examined for evidence of concurrent lumbar and cervical arthrosis. Concurrent arthrosis is a common condition with lumbar arthrosis preceding cervical arthrosis.

From the Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Cleveland, OH.

Acknowledgment date: September 8, 2008. Acceptance date: October 6, 2008.

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

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

This study did not require Institutional Review Board approval due to the exclusive use of de-identified cadaveric specimens.

The Hamann-Todd osteologic collection at the Cleveland Museum of Natural History provided all samples for this study. None of the authors received any financial support or materials from private, commercial, or government entities for this research.

Address correspondence and reprint requests to Daniel L. Master, MD, Department of Orthopaedic Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106; E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.