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18807

Title

Prevalence of herniated intervertebral discs of the cervical spine in asymptomatic subjects using mri scans: a qualitative systematic review [poster presentation; the Association of Chiropractic Colleges' Thirteenth Annual Conference, 2006]

URL

Journal

J Chiropr Educ. 2006 Spring;20(1):58

Author(s)

Subject(s)

Association of Chiropractic Colleges / congresses

Peer Review

Publication Type

Meeting Abstract

Abstract/Notes

INTRODUCTION: Forensic experts commonly cite studies that have determined the prevalence of intervertebral disc derangements—and in particular, disc herniations—of the cervical spine in asymptomatic subjects. Our objective was to review articles that report the prevalence of cervical disc herniations in asymptomatic subjects using MRIs and conduct a qualitative systematic review.

METHODS: A MEDLINE search for English language articles published between 1974 and 2004 was performed using the MeSH terms intervertebral disk, intervertebral disk displacement, MRI scans, and disk, herniated as well as the non-MeSH terms cervical disc, prevalence, and asymptomatic. The related articles/link feature of MEDLINE was used to identify articles similar to those retrieved from the initial search. Correspondence was initiated with the primary author of a seminal paper in this field to identify articles we may have overlooked. A total of six articles were retrieved. Loose inclusion criteria were applied to the articles because of the few retrieved. Articles not consistent with the purpose of this study were excluded. One study was excluded because it used CT and not MRI; therefore, five articles were retained in this review.

RESULTS: A study of 100 asymptomatic subjects (35 assessed retrospectively and 65 assessed prospectively) found 20% of subjects 45-54 years, 35% of subjects 55-64 years and 57% of subjects older than 64 years had cervical disc herniations/bulges. A second study involving 63 asymptomatic subjects found 10% of subjects less than 40 years and 5% of subjects older than 40 years had disc herniations. A third study of 89 asymptomatic subjects found that each of 2 subjects (one 29 and the other 56 years) had a disc prolapse; the prevalence was 2.2%. A fourth study of 497 asymptomatic subjects found that 70 of 2480 discs scanned were prolapsed posteriorly (2.8%), and reported that the frequency of these lesions increased after 40 years. A fifth study compared 15 asymptomatic and 16 symptomatic subjects after 7 years and found no disc herniations (0%) in the asymptomatic group and 4 disc herniations (25%) in the symptomatic group. In summary, the prevalence of cervical disc herniations in asymptomatic subjects less than 40 years of age is 3% to 10% and increases to 20% in subjects up to 54 years of age. The prevalence increases with age—from 5% to 35% in subjects between 40 and 64 years of age.

This abstract is reproduced with the permission of the publisher.

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