Coexistence of cervical and lumbar disc disease.

Abstract

A retrospective analysis of 200 patients requiring cervical disc surgery was performed to determine the frequency of coexistent lumbar disc or spine abnormalities. The duration of follow-up ranged from 5 to 25 years, averaging 14 years. Sixty percent were women and 40% were men, their ages ranging from 25-73 years. Antecedent motor vehicle injury had occurred in 49 cases and work injury to the spine in 23. Sixty-four percent had no history of prior back injury. It was found that over 31% had undergone lumbar disc surgery, and a high number of patients demonstrated abnormal lumbar radiographs or myelograms, including 78 with bulging discs, 100 with major root defects, 78 with minor root defects, 8 with spinal stenosis, and 7 with spondylolisthesis. Myelograms were normal in 22 cases. The sites of lumbar abnormalities included L4-5 (110), L5-S1 (90), and multilevel (8). There was a higher incidence of lumbar disc abnormalities associated with multilevel cervical spondylosis. There also was a relationship between residual symptoms and myelographic abnormalities. Two studies in the authors' institution suggest an autoimmune basis for the frequent coexistence of cervical and lumbar disc disease, namely the demonstration of antigenic properties in the nucleus pulposus and high serum immunoglobulins.