The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool.

Abstract

Several studies using magnetic resonance imaging (MRI) to evaluate the lumbar spine in adults have shown a large prevalence of degenerative changes in asymptomatic subjects; however, studies in pediatric patients are scarce. Those studies have suggested a lower rate of degenerative findings in adolescents than in adults, but the actual prevalence of MRI findings in the pediatric population has not yet been determined. We aimed to determine the prevalence of degenerative changes in the lumbar spine of pediatric patients using abdominal and pelvic MRI as the screening tool. We studied 103 patients (mean age 6.6 years) who were evaluated with abdominal and pelvic MRI for indications that were not spine related. The entire lumbo-sacral spine was evaluated to detect the presence of disc degeneration (DD), disc displacement, anular rupture with high-intensity zone (HIZ) and Modic changes. In our population, 10.7 % [4.9-16.5] had at least one disc classified as Pfirrmann 2, and no patients presented discs classified as Pfirrmann 3, 4 or 5; patients exhibiting discs classified as Pfirrmann 2 were significantly older than patients who had only Pfirrmann 1 discs. The prevalence of disc bulging was 1 % [0-2.9]. No patients presented disc herniation (including protrusion or extrusions); additionally, no patients exhibited HIZ or Modic changes. Incidental findings related to DD are very uncommon at this early age, in contrast to findings described in adults or later in adolescence.