A retrospective study 1. [Clinical Relationship of Degenerative Changes between the Cervical and Lumbar Spine] reviewing MRIs of 152 back patients showed a positive correlation between cervical and lumbar intervertebral disc degeneration (IDD) in patients presenting with lumbar spondylosis. The results suggest the necessity of screening LBP patients for evidence of cervical IDD.
The diagnosis of IDD may be complicated by the patient’s pain patterns and the tendency of practitioners to focus only on the area of discomfort. Studies have demonstrated the interrelatedness of spinal kinematics, reflexes, and complex neurogenic responses in IVD degeneration, but few studies have examined the connection between degenerative changes in the lumbar and cervical spine, as it relates to diagnosis. This study’s aim was to quantify the possible correlation, which could lead to better diagnostic and treatment outcomes for future IDD patients.
Positional MRIs of 152 patients presenting with cervical or lumbar spondylosis were reviewed and assessed and graded on a scale of 1 to 5 for every spinal segment. A degenerative disc score (DDS) was achieved by summing the grades across all segments, after which, the subjects were divided into two groups based upon their IDD for each spinal segment. The “normal” group received a grade of 1 to 2; the “degenerative” group had grades of between 3 and 5. The groups were then compared for evidence of a positive correlation.
A review of the two groups showed a positive correlation between DDS of the cervical and lumbar spine, with higher cervical DDSs at the upper lumber segments than at the lower degenerative segments. This indicates that patients demonstrating degenerations in the upper lumbar spinal segments are likely to suffer from some cervical spondylosis on further examination, regardless of whether they are currently symptomatic.
ConclusionPatients with lumbar degeneration should also be screened for cervical spondylosis, particularly if their lumbar degeneration is present in the L1 to L3, to reduce the likelihood of a missed cervical degeneration diagnosis. Click To Tweet
KEYWORDS: positive correlation between cervical and lumbar intervertebral disc degeneration, better diagnostic and treatment outcomes for future IDD patients, the interrelatedness of spinal kinematics, reflexes, and complex neurogenic responses, patients demonstrating degenerations in the upper lumbar spinal segments are likely to suffer from some cervical spondylosis