title: Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects.
abstract: METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  The purpose of this study was to determine the prevalence and distribution of abnormal findings on cervical spine magnetic resonance image (MRI).
  
  
  BACKGROUND
  Neurological symptoms and abnormal findings on MR images are keys to diagnose the spinal diseases. To determine the significance of MRI abnormalities, we must take into account the (1) frequency and (2) spectrum of structural abnormalities, which may be asymptomatic. However, no large-scale study has documented abnormal findings of the cervical spine on MR image in asymptomatic subjects.
  
  
  METHODS
  MR images were analyzed for the anteroposterior spinal cord diameter, disc bulging diameter, and axial cross-sectional area of the spinal cord in 1211 healthy volunteers. The age of healthy volunteers prospectively enrolled in this study ranged from 20 to 70 years, with approximately 100 individuals per decade, per sex. These data were used to determine the spectrum and degree of disc bulging, spinal cord compression (SCC), and increased signal intensity changes in the spinal cord.
  
  
  RESULTS
  Most subjects presented with disc bulging (87.6%), which significantly increased with age in terms of frequency, severity, and number of levels. Even most subjects in their 20s had bulging discs, with 73.3% and 78.0% of males and females, respectively. In contrast, few asymptomatic subjects were diagnosed with SCC (5.3%) or increased signal intensity (2.3%). These numbers increased with age, particularly after age 50 years. SCC mainly involved 1 level (58%) or 2 levels (38%), and predominantly occurred at C5-C6 (41%) and C6-C7 (27%).
  
  
  CONCLUSIONS
  Disc bulging was frequently observed in asymptomatic subjects, even including those in their 20s. The number of patients with minor disc bulging increased from age 20 to 50 years. In contrast, the frequency of SCC and increased signal intensity increased after age 50 years, and this was accompanied by increased severity of disc bulging.
  
  
  METHODS
  2.
authors.affiliation: *Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan †Department of Orthopedic Surgery, Chubu Rosai Hospital, Chubu, Japan ‡Department of Orthopedic Surgery, Hokkaido Chuo Rosai Hospital Sekison Center, Hokkaido, Japan §Department of Orthopedic Surgery, Chiba Rosai Hospital, Chiba, Japan; and ¶Department of Orthopedic Surgery, Spinal Injuries Center, Fukuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakashima
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Yukawa
authors.forename: Kota
authors.initials: K
authors.lastname: Suda
authors.forename: Masatsune
authors.initials: M
authors.lastname: Yamagata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ueta
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D066193:Cervical Cord / Q000473:pathology*; D002574:Cervical Vertebrae / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000473:pathology*; D055815:Young Adult