DEVELOPMENT OF DEGENERATIVE CHANGES IN THE LUMBAR INTERVERTEBRAL-DISK- RESULTS OF A PROSPECTIVE MR-IMAGING STUDY IN ADOLESCENTS WITH AND WITHOUT LOW-BACK-PAIN

PURPOSE: To investigate the frequency, pattern, and sequence of early degenerative changes in the lumbar spine. MATERIALS AND METHODS: On th e basis of a survey of 1,503 14-year-old schoolchildren, a randomized sample of 40 subjects with low-back pain (LBP) and 40 asymptomatic sub jects were invited to undergo magnetic resonance (MR) imaging of the l umbar spine at 15 and at 18 years of age. Altogether, 62 subjects part icipated in both studies. RESULTS: The frequency of disk degeneration at follow-up was greater in the patients with LBP (increased from 42% to 58%) than among the asymptomatic subjects (from 19% to 26%) (P = .0 1). No such difference was found with disk protrusion, although disk p rotrusion was seen only in subjects with LBP at baseline examination ( 19%). CONCLUSION: Degenerative changes emerge rapidly after the adoles cent growth spurt. The MR imaging appearance of the degenerative proce sses is similar regardless of symptoms, although these processes are m ore common in symptomatic adolescents and develop at an earlier age. T here appears to be a positive correlation between degenerative lumbar disk disease and LBP in adolescence.