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Degenerative Disorders of the Spine

Radiological Imaging

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Clinical Neuroradiology

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Abstract

Spinal pain and low back pain (LBP) are ubiquitous in all Western countries and represents the second leading cause of disability worldwide. The estimated lifetime prevalence rates of LBP and neck pain in adults are 91% and 66.7%, respectively, but the incidence is disproportionally rising with respect to the population growth. Degenerative disc disease (DDD) is a generalized multifactorial process involving the disco-vertebral joints, having genetic, inflammatory, traumatic, and nutritional bases and leading to morphological and biomechanical spine modifications. It is by far the most frequent cause of acute and chronic spinal pain.

Acute back pain has most commonly a benign and self-limiting evolution being pathologically due to an underlying benign disease in about 95% of cases and most patients need neither imaging nor invasive approaches. Imaging in acute setting has no role in the absence of clinical suggestion of underlying systemic disease (red flags) as well as of a progressive or severe neurologic deficit. Chronic spinal pain is a major welfare and economic concern, being responsible of about 70–90% of the total national compensation for disease-related expenditure in USA. Imaging is crucial but represents only a step of the assessment of spinal pain and its findings must always be related to anamnesis data and physical evaluation in order to be correctly evaluated.

In many cases, the significance of imaging data and the source of pain are challenging to be determined due to the complex anatomy and function of the spine as well as to the occurrence of the similar changes in asymptomatic and diseased subjects.

Postoperative imaging finding is important to understand posttreatment persistent pain.

This publication is endorsed by: European Society of Neuroradiology (www.esnr.org).

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Abbreviations

AF:

Annulus fibrosus

ALIF:

Anterior lumbar interbody fusion

CSF:

Cerebrospinal fluid

DDD:

Degenerative disc disease

DSL:

Degenerative spondylolisthesis

DWI:

Diffusion weighted imaging

FBSS:

Failed back surgery syndrome

FSE:

Fast Spin Echo

IASP:

International Association for the Study of Pain

IDD:

Internal disc destruction

ISL:

Isthmic spondylolisthesis

LBP:

Low back pain

MDCT:

Multi-detector computed tomography

MRI:

Magnetic resonance imaging

MS:

Motion segment

NP:

Nucleus pulposus

NPV:

Negative predictive value

PF:

Posterior fusion

PLF:

Posterior lateral fusion

PLIF:

Posterior lumbar interbody fusion

PPV:

Positive predictive value

SAC:

Space available for the cord

SCS:

Spinal canal stenosis

XLIF:

Extreme lateral interbody fusion

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Author information

Authors and Affiliations

  1. Department of Radiology, Fondazione IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy

    Teresa Popolizio

  2. Neuroradiologist Consultant, Department of Radiology, Fondazione IRCCS “Casa Sollievo della Sofferenza“, San Giovanni Rotondo, Foggia, Italy

    Roberto Izzo

Authors
  1. Teresa Popolizio
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  2. Roberto Izzo
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Corresponding author

Correspondence to Teresa Popolizio .

Editor information

Editors and Affiliations

  1. Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands

    Frederik Barkhof

  2. National Hosp.f Neurology & Neurosurgery, UCL National Hosp.f Neurology & Neurosurgery, London, UK

    Rolf Jager

  3. Division of Neuroradiology, University Hospital Vienna Division of Neuroradiology, Wien, Austria

    Majda Thurnher

  4. Department of Neuroradiology, Hospital Vall d’Hebrón Department of Neuroradiology, Barcelona, Spain

    Alex Rovira Cañellas

Section Editor information

  1. Neuroradiology Department, Cardarelli Hospital, Naples, Italy

    Mario Muto MD

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Popolizio, T., Izzo, R. (2019). Degenerative Disorders of the Spine. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_38-1

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  • DOI: https://doi.org/10.1007/978-3-319-61423-6_38-1

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