The Journal of Bone and Joint Surgery, Vol 77, Issue 11 1631-1638, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Magnetic resonance imaging of the thoracic spine. Evaluation of asymptomatic individuals
KB Wood, TA Garvey, C Gundry and KB Heithoff
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis 55407, USA.
We reviewed magnetic resonance imaging studies of the thoracic spines of
ninety asymptomatic individuals to determine the prevalence of abnormal
anatomical findings. This group included sixty individuals who had no
history of any thoracic or lumbar pain and thirty individuals who had a
history of low-back pain only. In addition, we reviewed imaging studies of
eighteen patients who had an operatively proved herniation of a thoracic
disc and studies of thirty-one patients who had been seen with thoracic
pain. Sagittal T1-weighted spin-echo and axial multiplanar gradient
refocused images at each disc level were interpreted by us (two
neuroradiologists and two orthopaedic spine surgeons); we had no clinical
information about the patients. Sixty-six (73 percent) of the ninety
asymptomatic individuals had positive anatomical findings at one level or
more. These findings included herniation of a disc in thirty-three subjects
(37 percent), bulging of a disc in forty-eight (53 percent), an annular
tear in fifty-two (58 percent), deformation of the spinal cord in
twenty-six (29 percent), and Scheuermann end-plate irregularities or
kyphosis in thirty-four (38 percent). This study documents the high
prevalence of anatomical irregularities, including herniation of a disc and
deformation of the spinal cord, on the magnetic resonance images of the
thoracic spine in asymptomatic individuals. We emphasize that these
findings represent roentgenographic abnormalities only, and any clinical
decisions concerning the treatment of pain in the thoracic spine usually
require additional studies.
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