Disc degeneration is thought by many to be at the root of back and neck pain.
However, measuring degeneration has always been a challenge because of its elusive nature. One characteristic of degeneration that all agree on is disc height, or in other words, the spacing between vertebra. It is one of the most looked for finding on MRI, x-ray and CT when evaluating for a patient’s pain.
In a recent research paper by Andrew J. Teichtahl et al. in Arthritis Research & Therapy (2015) 17:297 DOI 10.1186/s13075-015-0820-1, these researchers found a dose-response relationship between the severity of disc degeneration and lumbar disc height.
The authors believe that their study provides the first evidence that lumbar disc height is a reliable and easily accessible measure in the determinant of lumbar disc degeneration.
Lumbosacral disc degeneration is very common with as many as one third of individuals showing disc degeneration in this region when investigated with MRI. Furthermore, with degeneration, it increases the risk by two-fold in the development of chronic low back pain. With these facts at hand, it is imperative to measure disc degeneration but this is not as easy as thought because of the varying definitions. Disc degeneration can be a complex condition with characteristics of cell proliferation, nucleus pulposus dehydration, annular fissures and clefts, endplate disruption and granulation changes.
Radiographic evidence of disc degeneration can also demonstrate endplate sclerosis, osteophytosis and joint space narrowing (aka, disc height). The most recognized technique to evaluate the degree of disc degeneration is the Pfirrmann’s method which is endorsed as a valid and reliable method of assessing intervertebral disc degeneration using MRI.
These researchers looked at MRIs from 72 community based individuals and found that disc height was the best quantitative measure as an outcome measure in epidemiological studies.
Dynamic Disc Models enables spine doctors to share important clinical findings ,like disc height, to patients in a dynamic and interactive way, demonstrating facet shingling, intradiscal findings and disc herniation on a dynamic platform to improve education of pain generators. An educated patient often is more compliant as they understand more clearly the movements and activities that can exacerbate their symptoms like excessive spinal flexion and incorrect lifting.