Sex- and Age-related Differences in Spinal Degeneration: An Anatomical and Magnetic Resonance Imaging Study of the Human Spine

OBJECTIVES: A precise anatomical understanding of the morphology of the spine is indispensable for neck and low back pain therapy including rehabilitation. However, few studies have directly addressed spinal morphology with a focus on the height of the vertebral body and discs. The aim of the current study was to analyze sex- and age-related changes in the spine by measuring the distance between adjacent centers of the intervertebral disc spaces from the posterior aspect in cadavers and by using magnetic resonance imaging (MRI) measurements at the cervical and lumbar vertebral levels. METHODS: In the cadaveric study, the posterior distance between the adjacent centers of the disc spaces was measured for 58 spinal canals. The equivalent distances were examined using MRI in 370 and 660 subjects who presented with neck pain and back pain, respectively. RESULTS: The distance between the adjacent centers of the intervertebral disc spaces in male cadavers was larger than that in female cadavers from C3 to L5/S1. The MRI results showed that the distance between the adjacent centers of the intervertebral disc spaces decreased with age in all spinal areas in men and women. Cadaveric values were significantly lower than the MRI values in men, whereas in women, no significant differences were observed. CONCLUSIONS: These results suggest that age-related changes in the cervical and lumbar spine are associated with differences between men and women in the degrees of progressive vertebral body and disc degeneration.