Premature Disc Degeneration

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Abstract
The lower lumbar discs of 62 children and adolescents were evaluated by magnetic resonance imaging (MRI) to elucidate the role of disc pathology as a possible source of pain in isthmic spondylolisthesis. The subjects were allocated into four groups: group A, asymptomatic isthmic L5 slip (mean 17.9%, n = 15); group B, symptomatic L5 slip (mean 16.6%, n = 10); group C, idiopathic scoliosis (mean Cobb angle 29.9°, n = 18); and group D, normal controls (n = 19). The fifth lumbar disc was pathologic in 100% of groups A and B, in 27.8% of group C, and in 36.8% of the control group D. Pathologic disc changes below the slipped vertebra appear to be the rule in growing individuals with isthmic spondylolisthesis whether they are symptomatic or not. The origin of the pain remains unclear. The findings support the assumption that disc pathology could be a primary factor in the pathogenesis of spondylolysis and olisthesis.

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