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Thirty-six percent of the 98 asymptomatic subjects had normal disks at all levels.With the results of the two readings averaged,52 percent of the subjects had a bulge at least one level,27 percent had a protrusion,and 1 percent had an extrusion.Thirty-eight percent had an abnormality of more than one intervertebral disk.The prevalence of bulges,but not of protrusions,increased with age.The most common nonintervertebral disk abnormalities were Schmorl's nodes(herniation of the disk into the vertebral-body end plate),found in 19 percent of the subjects;annular defects(disruption of the outer fibrous ring of the disk),in 14 percent; and facet arthropathy(degenerative disease of the posterior articular processes of the vertebrae),in 8 percent.The findings were similar in men and women.On MRI examination of the lumbar spine,many people without back pain have disk bulges or protrusions but not extrusions.Given the high prevalence of these findings and of back pain,the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental. |
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