Epidemiology and risk factors associated with Lumbosacral Juvenile Degenerative Disc Disease (JDDD)

Abstract

Juvenile degenerative disc disease (JDDD) has been highly associated with spinal deformities. However, little is known regarding JDDD in the context of non-spinal deformities. In addition, the role of associated risk factors in JDDD in comparison to normal subjects remains speculative. As part of the largest population genetic-based study in Southern Chinese (n=1,989), subjects aged 13 to 21 years were grouped into JDDD and non-JDDD cases to assess the epidemiology and risk factors associated with JDDD of the lumbosacral spine. T2-weighted MRI findings were evaluated. Subject demographics and clinical profiles were collected by a standardised questionnaire. JDDD was present in 34.9% (n=29) of the study sample (n=83). The prevalence of single-level JDDD and two-level JDDD were 69% and 20.7%, respectively. The L5/S1 level was predominantly involved in single (48.3%) and in multi-level (77.8%) JDDD. Radiological abnormalities of disc bulge/extrusion (OR: 100; 95% CI: 25.00-400.02) and high-intensity zones (OR: 8.2; 95% CI: 1.17-56.59) were significantly more prevalent in JDDD, without occurrence in non-JDDD. BMI (OR: 1.2; 95% CI: 1.00-1.37), history of lumbar injury (OR: 6.1; 95% CI: 1.9-19.4), and a significantly worse clinical historical profile of back pain and/or sciatica were strongly associated with JDDD. In non-spinal deformity cases, individuals with lumbosacral JDDD are noted to be more symptomatic, have higher BMIs, and a significant history of previous lumbar injury in comparison to non-JDDD subjects.