Development of degenerative changes in the lumbar intervertebral disk: results of a prospective MR imaging study in adolescents with and without low-back pain.

PURPOSE: To investigate the frequency, pattern, and sequence of early degenerative changes in the lumbar spine. MATERIALS AND METHODS: On the basis of a survey of 1,503 14-year-old schoolchildren, a randomized sample of 40 subjects with low-back pain (LBP) and 40 asymptomatic subjects were invited to undergo magnetic resonance (MR) imaging of the lumbar spine at 15 and at 18 years of age. Altogether, 62 subjects participated in both studies. RESULTS: The frequency of disk degeneration at follow-up was greater in the patients with LBP (increased from 42% to 58%) than among the asymptomatic subjects (from 19% to 26%) (P = .01). No such difference was found with disk protrusion, although disk protrusion was seen only in subjects with LBP at baseline examination (19%). CONCLUSION: Degenerative changes emerge rapidly after the adolescent growth spurt. The MR imaging appearance of the degenerative processes is similar regardless of symptoms, although these processes are more common in symptomatic adolescents and develop at an earlier age. There appears to be a positive correlation between degenerative lumbar disk disease and LBP in adolescence.