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Lumbar disc degeneration and atherosclerosis of the abdominal aorta
L I Kauppila1, A Penttilä, P J Karhunen
1Department of Forensic Medicine, University of Helsinki, Finland.
Insights
Lumbar disc degeneration is linked to atherosclerosis in the abdominal aorta and stenosis of the lumbar and sacral arteries. These vascular conditions, particularly arterial stenosis, contribute to disc degeneration, especially in the upper lumbar spine.
Area of Science:
- Orthopedics
- Vascular Biology
- Radiology
Background:
- Lumbar disc degeneration is a common cause of low back pain.
- Atherosclerosis is a systemic disease affecting arteries throughout the body.
Purpose of the Study:
- To investigate the association between lumbar disc degeneration and atherosclerotic changes in the abdominal aorta.
- To examine the relationship between disc degeneration and stenosis of the ostia of lumbar and middle sacral arteries.
Main Methods:
- Analysis of 86 plain radiographs of lumbosacral spines and corresponding abdominal aortas from routine autopsies.
- Evaluation of disc degeneration, abdominal aortic atherosclerosis, and arterial ostial stenosis.
Main Results:
- Disc degeneration, atherosclerosis, and arterial stenosis all increased with age.
- A significant association persisted between disc degeneration and arterial stenosis after controlling for age.
- This association was stronger in the upper lumbar spine and intensified with more complex aortic lesions.
Conclusions:
- Atherosclerosis of the abdominal aorta is associated with lumbar disc degeneration.
- Stenosis of the ostia of segmental arteries is a significant factor in lumbar disc degeneration.
Study Design:
This study analyzed the relationship of disc degeneration to atherosclerotic changes in the abdominal aorta and stenosis of the ostia of the lumbar and middle sacral arteries, 86 plain radiographs of lumbosacral spines, and the corresponding abdominal aortas were evaluated in connection with routine autopsy.
Results:
Disc degeneration, advanced atherosclerotic manifestations, and stenosis of the ostia of the lumbar and middle sacral arteries all increased with age (P < 0.001). After partial rank correlation analysis, keeping the effect of age constant, there was still a statistically significant association between the grade of disc degeneration and stenosis of the ostia of the arteries supplying the disc. The association was stronger at upper lumbar levels (0.001 < P < 0.01) than at lower ones (0.01 < P < 0.05). Furthermore, with complicated lesions in the abdominal aorta, disc degeneration at all lumbar levels increased.
Conclusions:
Atherosclerosis in the abdominal aorta and especially stenosis of the ostia of segmental arteries may play a part in lumbar disc degeneration.