RT Journal
A1 Bolesta, Michael J.
T1 Commentary on an article by Dino Samartzis, DSc, et al.: “A Population-Based Study of Juvenile Disc Degeneration and Its Association with Overweight and Obesity, Low Back Pain, and Diminished Functional Status”
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD April 6
VO 93
IS 7
SP e34 1
OP 2
DO 10.2106/JBJS.J.01854
UL http://dx.doi.org/10.2106/JBJS.J.01854
AB 
Samartzis and his colleagues report on a cross-sectional study of Chinese youth, aged thirteen to twenty years. Out of a larger cohort of 1989 Southern Chinese volunteers, they identified eighty-three individuals in this particular age group who did not have spinal deformity. Fifty-four of them, twenty-two males and thirty-two females, had no evidence of disc degeneration on a T2-weighted sagittal magnetic resonance imaging (MRI) of the lumbar spine. Twenty-nine, sixteen males and thirteen females, did exhibit MRI evidence of juvenile disc degeneration. Statistical analysis showed no significant difference in age or sex between the two groups. However, weight, height, and body-mass index (BMI) were all significantly higher in the group with juvenile disc degeneration. The odds ratio for having disc degeneration was 14.19 (95% confidence interval [CI], 1.44 to 140.40) if an individual was overweight or obese compared with underweight. Interestingly, it was a remarkable 11.70 (95% CI, 1.34 to 102.37) even if the BMI was normal; again, note that the risk was relative to being underweight. The broad confidence intervals are also important to note. The odds ratio for having juvenile disc degeneration was 6.57 (95% CI, 1.96 to 22.02) for subjects who recalled sustaining a lumbar injury. Cigarette usage, exercise level, and Schmorl nodes did not predict juvenile disc degeneration. MRI findings in the group with juvenile disc degeneration were disc bulges or extrusions and high-intensity-zone lesions. The number of levels involved ranged from one to three, with a mean of 1.3 levels, and the average disc degeneration score was 2.9 (range, one to nine).