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bibliography*The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Dammers 2002.

Lumbar disc herniation level increases with age


Tags: back pain, counter-intuitive, arthritis, chronic pain, pain problems, spine, aging

PainSci summary of Dammers 2002?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

Age correlates strongly with the location of spinal disc herniations: the older you are, the higher the herniation is likely to be. This does not mean disc herniation is more common or severe with age. It’s a curious finding, but it’s clinical and pathological significance is unknown. It is, however, blatantly the opposite of what “common sense” tells us to expect: it’s not the most load-bearing (lowest) joins of the spine that fail with age.

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Prompted by the clinical impression that L4 radicular syndrome and disc herniations at L3-4 occurred at older ages we studied the correlation between age and level of herniated discs.

METHODS: We retrospectively correlated mean age and level of disc herniation of patients suffering from lumbar disc herniation. Data from 1431 patients were obtained from the neurologic database of the Atrium Medical Center Heerlen from 1995 through 1998. Nonparametric data were analyzed with the Mann-Whitney U test, and correlation was analyzed using linear regression.

RESULTS: Mean ages of the patients with disc herniation at L5-S1, L4-5, L3-4, and L2-3 were 44.1 +/- 0.5 years, 49.5 +/- 0.6 years, 59.5 +/- 0.9 years, and 59.6 +/- 2.7 years, respectively. Mean ages were significantly higher with herniation levels at L4-5, L3-4, and L2-3 compared to L5-S1 (p < 0.0001). Analogously, the mean age of patients with disc herniation at L3-4 was significantly higher compared to those with herniation at L4-5 (p < 0.0001). No difference in mean age was seen between L3-4 and L2-3 (p = 0.815). A strong correlation was observed between the level of herniation and increasing age (R = 0.371; p < 0.0001).

CONCLUSION: These results indeed prove that with increasing age, lumbar disc herniation is more cranially localized. It may help in understanding the patho-anatomic process of disc herniation, and in recognizing higher level radicular syndromes in advanced age.

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