DEGENERATION PATTERNS ACROSS THE SPINE: CERVICAL VS. LUMBOSACRAL INSIGHTS

Low back and neck pain are widespread issues with significant social and economic implications, often resulting from disc degeneration. While disc and vertebral degeneration are interconnected, variations in degeneration patterns between the cervical and lumbosacral regions remain underexplored. Understanding these differences is crucial for diagnosing and treating spinal disorders effectively. This study aims to compare the onset and progression of disc degeneration in the cervical and lumbosacral regions and perform an intra-patient analysis to assess region-specific degeneration patterns within the same individuals. We conducted a comprehensive MRI analysis of 150 patients, categorized into three groups: cervical spine MRI, lumbosacral spine MRI, and combined cervical/lumbosacral MRI. Disc degeneration was graded using the Pfirrmann classification, endplate degeneration with the Modic classification, osteophytes and hemangiomas were also assessed. Statistical analyses included tests of normality, Spearman's rank correlation, logistic regression, and descriptive statistics to examine degeneration patterns and correlations between Pfirrmann grades and Modic changes. Cervical and lumbar regions both showed moderate to advanced degeneration (Pfirrmann grades 2-4), but severe degeneration (grade 5) was more prevalent at lower lumbar levels (L4/L5, L5/S1) compared to the cervical spine. Modic changes were more frequent in the lumbar spine, particularly at L4/L5 and L5/S1. Intra-patient analysis revealed stronger correlations between degeneration at adjacent lumbar levels compared to cervical levels, indicating more widespread and severe degeneration in the lumbar region. Logistic regression demonstrated a significant association between hemangiomas and higher Pfirrmann grades in the lumbar spine. The findings suggest distinct patterns of disc degeneration between the cervical and lumbar spine, with more severe and widespread degeneration in the lumbar region. This observation underscores the possible association of hemangiomas with spinal degeneration, suggesting a potential role in the degenerative process.