D’Antoni AV, Croft AC. Prevalence of Herniated Intervertebral Discs of the Cervical Spine in Asymptomatic Subjects Using MRI Scans: A Qualitative Systemic Review. Journal of Whiplash & Related Disorders 2006; 5(1):5-13.
ABSTRACT: Introduction: Our objective was to review articles that report the prevalence of cervical disc herniation in asymptomatic subjects using MRIs and conduct a qualitative systemic review. Methods: A MEDLINE search for articles published between 1974 and 2004 was performed, and five articles were retained in this review. Results: Teresi et al. (1987) studied 35 asymptomatic subjects retrospectively and 65 asymptomatic patients prospectively, and found 20% of subjects aged 45-54 years, 35% of subjects aged 55-64 years, and 57% of subjects older than 64 years had cervical disc herniations/bulges. Boden et al. (1990) studied 63 asymptomatic subjects and found 10% of subjects of less than 40 years and 5% of subjects older than 40 years had disc herniations. Lehto et al. (1994) studied 89 asymptomatic subjects and found that each of 2 subjects (one 29 and the other 56 years) had a disc prolapse; the prevalence was 2.2%. Matsumoto et al. (1998) studied 497 asymptomatic subjects. They found that 70 of 2480 discs scanned were prolapsed posteriorly (2.8%), and reported that the frequency of these lesions increased after 40 years. Siivola et al. (2002) compared 15 aysmptomatic and 16 symptomatic subjects after 7 years and found no disc herniations (0%) in the asymptomatic group and 4 disc herniations (25%) in the symptomatic group. Conclusions: The prevalence of cervical disc herniations in asymptomatic subjects of less than 40 years of age is 3% to 10% and increases to 20% in subjects up to 54 years of age. The prevalence increases with age—from 5% to 35% in subjects between 40 and 64 years of age. COMMENTS: As might be expected, the prevalence of disc herniations in asymptomatic subjects increases with age. Obviously more studies are needed as there was a wide disparity in the statistics between papers and some sample sizes were quite small.