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To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time.In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature.Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD.KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.

Original publication

DOI

10.1093/rheumatology/kex040

Type

Journal article

Journal

Rheumatology (Oxford, England)

Publication Date

07/2017

Volume

56

Pages

1189 - 1199

Addresses

Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany.

Keywords

European Vertebral Osteoporosis Study and European Prospective Osteoporosis Study Groups, Humans, Osteoporosis, Radiography, Severity of Illness Index, Prevalence, Cohort Studies, Prospective Studies, Reproducibility of Results, Age Distribution, Sex Distribution, Bone Density, Aged, Middle Aged, Europe, Female, Male, Osteochondrosis, Intervertebral Disc Degeneration