Association between age, sex, BMI and CT-evaluated spinal degeneration features

The aim of our study was to evaluate the association between age, sex and body mass index (BMI) and lumbar spine degeneration features evaluated on computed tomography (CT) in a community-based sample.

This cross-sectional study was an ancillary project to the Framingham Study. A sample of 3529 participants of the Framingham study aged 40-80 had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this ancillary study. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (OA), spondylolysis, spondylolisthesis and spinal stenosis were evaluated. To evaluate the association between spinal degeneration features and age, sex and BMI we used chi2 test and logistic regression analyses.

104 men and 83 women, mean age 52.6 +/- 10.8 participated in the study. Statistically significant sexual dimorphism was found in prevalence of spondylolysis (p = 0.015) the male-to-female ratio was 3.3:1; and degenerative spondylolisthesis (p=0.008), the male-to-female ratio was 1:2.8. Prevalence of disc narrowing, facet joint OA, and degenerative spondylolisthesis showed a significant linear trend (p < 0.0001) of association with increasing age. Significantly higher prevalence of facet joint OA was found in the obese group OR (95%CI): 2.8 (1.1-7.2).

Marked differences in the prevalence of spinal degeneration features occur in association with age, sex and obesity. Given the high prevalence of many of these degeneration features these simple demographic factors should be considered when interpreting imaging results reporting these features.