Back pain is an important problem that affects two-thirds of adults at some time in their lives. One of the leading causes of functional incapacity is spinal degeneration, which is a common source of chronic disability in the working population. Disk degeneration has been linked to mechanical loading, which occurs most typically in the lower cervical and lower lumbar spinal regions. Degeneration of the intervertebral disc can result in annular tears and disc hernation, with compromise or compression of the nerve roots. Dehydration and disintegration of the disc tissue leads to increased segmental mobility. In some patients, instability with symptomatic osteochondrosis develops. Facet joint osteoarthritis can also be responsible for central spinal canal stenosis and stenosis of the recess or narrowing of the neuroforamen. Ganglion cysts are complications of facet joint osteoarthritis, that may lead to further stenosis of the spinal canal.Crystal deposition such as calcium pyrophosphate dihydrate (CPPD) or urate crystals may lead to degeneration of the intervertebral discs, although the latter are less common at the spine. On the other hand, metaplastic ossification of soft tissues such as the annulus fibrosus do occur during mechanically induced degeneration of the discs.
This lecture will review important magnetic resonance imaging signs in degenerative spinal disorders and compare those to conventional radiography, and computed tomography, as appropriate.
Disclosure of Interest K. G. Hermann Conflict with: MSD, AbbVie, UCB, Pfizer