The Medicare Claims 5% Limited Data Set (LDS) represents about 1.61.8 million individuals per calendar year. The Discseel Procedure is a non-surgical, minimally invasive treatment known to be able to both seal and heal annular tears, the cause of degenerative disc disease pain, preventing further leaking and providing long-term relief. 12(Suppl 2), S86S89. Spine J. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. He established a Spine Fellowship program and continues training physicians from around the world. Milne, J. S. & Williamson, J. 2005; 57(4 Suppl): 256-261. The results are discussed in comparison to published research pertaining to the prevalence of specific diagnoses. He then attended Northwestern University Internal Medicine Program, followed by a Neurology Residency Program at Emory University. A prospective investigation. Millions of patients will benefit from his development of minimally invasive treatments for degenerative disc disease and other more common and serious disorders of the spine. While the nuances of eligibility for Medicare and how coverage works for individuals with additional private health insurance are beyond the scope of this work, broadly speaking, the vast majority individuals over this age in the U.S. will have their medical claims submitted to Medicare. The patient has degenerative disc disease at L4-L5. This wear and tear is a form of arthritis, which is where the cartilage in the spine joints begins to wear out. Sci Rep 11, 5389 (2021). The prevalence and under-diagnosis of vertebral fractures on chest radiograph. Figure4 compares the prevalence of degenerative spine diagnoses in the overall sample and in the sub-sample with radiology. Spine 30(10), 11881196. Trends in osteoporosis and low bone mass in older US adults, 20052006 through 20132014. Also know what the side effects are. He works closely with the area internists, physical therapists, chiropractors, psychiatrists, neurologists, and spine surgeons to insure that each patient has the most optimal individualized treatment plan. AP and lateral upright weight bearing images show normal alignment and disc height (Figs 1A, 1B). 2005; 2: 660-667. (2013) estimated a prevalence of 5.7% for stenosis in the lumbar spine28. Commun. A study of young women in their twenties found that 31% of the women enrolled in the study were living with degenerative disc disease that progressively worsened throughout the course of the study. Types of spinal degenerative pathologies examined in this study include stenosis, spine curvatures (kyphosis, lordosis, and scoliosis), diffuse idiopathic skeletal hyperostosis (DISH), spondylitis, osteoporosis, and disc degeneration. He is passionate about functional medicine which focuses on restoring patients lives through healing using regenerative medicine procedures. Clinical Neurosurgery. The prevalence was 0.008% in 2005 and 0.049% in 2017, possibly reflecting increased use of medical imaging and/or recognition of the pathology. Psychological and psychosocial factors may be at play as well. This patient has had symptoms for 6 months. Another test that can be done to see if the nerves are involved is called an electromyography (EMG) or a nerve conduction study (NCS). Daily activities and sports, which cause tears in the outer core of the disc. Dr. Pearl is Triple Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology and has over 20 years experience in doing these procedures.Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeths Medical Center, where she was also the Director of the Pain Management Fellowship program.After graduating from Harvard College with an A.B. As a result of growth and opportunity, Dr. Foxx partnered to create Midwest Orthopedic Network Kansas and surgery center in Overland Park, KS. Questions may include: Your healthcare provider may use imaging scans such as X-ray, CT or MRI. Member, Massachusetts Department of Industrial Accidents, Health Care Services Board, Member of the Association of Harvard College Class Secretaries and Treasurers, Past Member of the Board of Directors of the Harvard Alumni Association, Former Member of the Board of Trustees University of Massachusetts. Dr. Pearl was the first resident ever to serve on the Accreditation Council for Graduate Medical Education (ACGME)s Residency Review Committee for Anesthesiology. Dr. Terebuh is a very unique Medical Doctor because he has earned seven Board Certifications in the field of musculoskeletal medicine and nonsurgical spine care. There may . Pediatric and adult three-dimensional cervical spine kinematics: Effect of age and sex through overall motion. In my hands, this procedure has the least amount of morbidity to the paraspinal musculature, while effectively immobilizing the abnormal segment with a high potential for fusion through the interbody space. https://doi.org/10.1016/0021-9290(89)90036-5 (1989). This places increased strain and stress on your spinal discs that can lead to the development of annular tears. As discs between the vertebrae become thinner, more pressure is transferred to the facet joints. The condition occurs when discs that sit between each vertebra in the spine begin to break down and lose some of their height, which can cause painful changes like bulges or herniated discs. J. Spine 34(9), 955961. 18(6), 893900. The yearly prevalence of spine degeneration was 27.31.7% overall (meanstandard deviation among years). Most of the time when there is a little arthritis in the spine, the affected person never knows that it has developed. If it appears that the arthritis of the spine is not too severe and the nerves are not involved, then the physician will give you arthritis medicines and perhaps pain pills to get the irritation under control. Levoscoliosis is a type of spinal curvature that occurs when the spine curves to the left in a "C" shape. His passion for learning from the best, refusing to go with the flow and implementing new, less-invasive and progressive procedures naturally led him to the decision to sacrifice his well-established position and open his own clinic where he can truly make a difference by allowing those state-of-art methods become widely available to patients throughout Japan and Asia. Dr. Moradians clinical practice is devoted to the comprehensive care of spine, joint, muscle, tendon, ligament, and peripheral nerve disorders. Dr. Wiederholz is the fellowship director for the sports and spine fellowship at Performance Spine & Sports Medicine. Surgery. Worsens with sitting, bending or lifting. Article Nachemson, A., Schultz, A. 433457 (Academic Press, Boston, 2014). The bone where the injury occurred becomes relatively unstable. Another sign of nerve involvement is tingling and numbness (called paresthesia) in the arm or fingers. Especially after age 40, most people experience some disk degeneration. When pain is severe, you may benefit from spinal injections or spine surgery. This is consistent with our overall analysis and may be somewhat lower because of the inclusion of people between age 50 and 65. & Goel, V. K. Contribution of disc degeneration to osteophyte formation in the cervical spine: A biomechanical investigation. Bone Jt. Part 7: intractable low back pain without stenosis or spondylolisthesis. https://doi.org/10.1227/neu.0000000000000944 (2015). It is difficult to pinpoint a typical age for . https://doi.org/10.3174/ajnr.a4173 (2015). Herniated discs cause persistent low back pain in one to two percent of the population from 35 to 45 years old. When we are born, the disc is about 80 percent water. Spine Surg. (2019) reported that the presence of spinal degeneration was associated with spinal fracture-dislocation and spinal cord injury in rear-impact motor vehicle crashes with characteristics such that these injuries were unexpected38,39. ICD-9 codes were used from 2005 to the end of September 2015, and ICD-10 codes were used for from October 1, 2015 and onward. Degenerative disc disease (DDD) is a condition where one or more discs in the back lose their strength. The doctor will take your history and do an examination of the muscles and nerves in your arms. If the disc tears in this area, it can become quite painful. This can result in low back pain. The prevalence of osteoporosis was higher in females than males (14.3% vs. 2.1%). This study evaluates the prevalence of diagnosis of selected degenerative spinal pathology diagnoses using Medicare insurance claim data in the context of published smaller-scale studies. 28(6), 19791988. As a previous low back patient suffering from debilitating pain, he understands the importance of minimally invasive procedures that help restore the lumbar and thoracic spine. Degenerative disk disease is the result of multiple factors, some that can be controlled and others that cannot. In this study, diagnostic codes were used to identify the prevalence of degenerative spinal pathologies and differences based on age, sex, and obesity from Medicare data. Should the patient fail all conservative measures, I would consider surgery to treat the L4-L5 segment only as a last resort. His practice has over 5000 active patients in his practice. (1989) tested spines with and without spine degeneration and reported lower biomechanical tolerance with degeneration49. The spine is the central supporting structure of the torso; it routes and protects the spinal cord while providing for flexibility and shock absorption. Thus, healthcare service claims derived from the Medicare system broadly represents a wide spectrum of the US elderly population. Increased use of medical imaging may help explain the increased prevalence of degenerative spine diagnoses over time. He completed a Physical Medicine & Rehabilitation residency at The Ohio State University (96) after graduating from Georgetown Medical School (92). But they are not a long-term treatment for severely degenerated disks. If youre ready to get long-term relief from your back or neck pain with a treatment that wont limit your mobility, apply for the Discseel Procedure today and find out if youre a candidate for this procedure that has helped so many people living with back and neck pain. SAE Technical Paper 2020-01-0520. https://doi.org/10.4271/2020-01-0520 (2020). Spine 12, 739743 (1987). The signs of worsening nerve damage would be increasing tingling or numbness, weakness and sometimes increasing pain. Wang et al. and JavaScript. This curve usually starts in the lower back. Dr. Janet Pearl has been in practice since 1999 and is the Medical Director ofThe Boston Stem Cell Center. Google Scholar. The prevalence of spine degeneration was second highest for osteoporosis (8.91.0%). Degenerative disk disease is most common in older adults. The best way to think of discs is as cream-filled donuts, or perhaps as jelly-filled radial tires. A wide range of symptoms and severity is associated with this condition. The condition is most common in older adults. Kalichman, L., Guermazi, A., Li, L. & Hunter, D. J. 20(10), 11031108. Always follow your healthcare professional's instructions. When arthritis of the neck becomes a problem, the signs can be pain in the neck and occasionally in the shoulder blades, into the shoulders and down the arm to the hand. If those measures do not work or if there are signs of nerve damage, then more tests may be needed. One of the more unfortunate aspects of getting older is that your joints begin to wear out, oftentimes for no good reason. Dr. Buyanov is originally from Kiev, Ukraine. Figure1 shows the prevalence of spine degeneration diagnoses by age group, sex, and type. All rights reserved. Sometimes the neck gets irritated enough that the nerves become involved, and when that happens there may be pain that radiates down the arm to the wrist or fingers. (1990) indicated that 80% of asymptomatic patients 60years and older had cervical disc degeneration25. As the bones get closer together, they experience more and more stress. https://doi.org/10.1007/s00198-017-3996-1 (2017). Boris Terebuh, MD specializes in providing personalized nonsurgical solutions for spine problems that interfere with the function patients desire and the independence they deserve. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. J. Rheumatol. Figure2 shows the prevalence of degenerative spine diagnoses by calendar year, type, and sex. There are a number of things that can cause annular tears, some of which are out of anyones control, but there are a few things you can do to help prevent their development. Rheum. The 5% LDS typically follows the same individuals for multiple years until their death. Other studies have reported higher prevalences for certain demographics (Online Appendix 12). The LDS comprises a 5% random national sample of Medicare enrollees and provides their associated physician service claims. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. She is also the Medical Director ofComplete Spine and Pain Care an interventional integrated Pain Management practice,both located in Framingham, Massachusetts. Spine degeneration diagnosis prevalence by age group and sex. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the departments Excellence in Teaching award during her year as Chief Resident. I would consider 3 surgical options: a direct lateral approach, a posterolateral fusion, or a TLIF. Jun 16, 2021 David W. Polly, Jr., MD Professor and Chief of Spine Surgery Commentary Praveen V. Mummaneni, MD Patient History Prior studies generally investigated much smaller groups and focused on one spinal pathology, sometimes in the context of risk factors or common comorbidities. Degeneration itself is normal, and does not necessarily cause pain. He is the founder and owner of Champlain Spine and Pain Management and of Surgical Pain Center of the Adirondacks. 2004; 1:24-30. 6A, 6C), and interbody spacer at L4-L5 (Fig. As we age, the disc dries out and doesn't absorb shocks as well. He has been at the forefront of his field for years and offers the most advanced, cutting-edge interventional treatments in the field of pain management. Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nations most prestigious hospitals. Resnick, D., Shaul, S. R. & Robins, J. M. Diffuse idiopathic skeletal hyperostosis (DISH): Forestiers Disease with extraspinal manifestations. The spine is made up of joints that allow movement and disks that provide cushioning. Dr. Buyanov strongly believes in an individualized and multidisciplinary approach to pain management, he believes in the Buddhist saying: pain is inevitable but suffering is optional. If these proteins leak out to the nerves of the outer layer of the disc, they can cause a great deal of pain. 30(9), 10691072. How can I prevent pain from returning after surgery. Eur. The MRI demonstrates L4-L5 degenerative disc disease (confirmed by discography) and the flexion-extension X-rays demonstrate a minimal retrolisthesis of L4 on L5 in extension. Chronic low back pain in young people is becoming an increasing problem. https://doi.org/10.1007/s00586-013-2865-7 (2013). Spine 22(24), 25S-31S. Being advanced fellowship trained in Anti-Aging, Regenerative & Functional Medicine means that Dr. Wiederholz has the most advanced training in Anti-Aging Medicine available. PubMed The body restabilizes the injured segment of the back. A firm, tough outer layer, the anulus fibrosus. Know why a test or procedure is recommended and what the results could mean. In these two tests, a physician uses instruments to evaluate the muscles and nerves to see if they are carrying the signals from the spine to the arms properly. Strong association of type 2 diabetes with degenerative lumbar spine disorders, Nationwide sample data analysis of additional surgery rate after anterior or posterior cervical spinal surgery, Spinal degeneration is associated with lumbar multifidus morphology in secondary care patients with low back or leg pain, Increased incidence of vertebral fractures in German adults from 2009 to 2019 and the analysis of secondary diagnoses, treatment, costs, and in-hospital mortality, Trends in nonroutine physician visits and hospitalizations: findings among five cohorts from the Spinal Cord Injury Longitudinal Aging Study, Etiology-specific variation in survival following non-traumatic spinal cord injury: a causal inference approach using data from a population-based cohort, All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based cohort study in Switzerland, Trends in the prevalence and incidence of ankylosing spondylitis in South Korea, 20102015 and estimated differences according to income status, Prevalence of chronic health conditions and hospital utilization in adults with spinal cord injury: an analysis of self-report and South Carolina administrative billing data, https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets, https://www.cdc.gov/nchs/products/databriefs/db219.htm, https://doi.org/10.1097/00007632-199712151-00005, https://doi.org/10.1097/00007632-197901000-00001, https://doi.org/10.1097/brs.0b013e3181ab65c6, https://doi.org/10.1097/01.brs.0000162280.95076.bb, https://doi.org/10.1007/s00586-003-0593-0, https://doi.org/10.1227/neu.0000000000000944, https://doi.org/10.1080/15389588.2017.1309526, https://doi.org/10.1007/s00198-017-3996-1, https://doi.org/10.1093/rheumatology/29.2.131, https://doi.org/10.1080/030097402320318422, https://doi.org/10.1016/j.spinee.2017.08.240, https://doi.org/10.1097/bsd.0000000000000919, https://doi.org/10.1007/s00586-009-0932-x, https://doi.org/10.1097/brs.0b013e31819e2fd5, https://doi.org/10.1007/s00776-013-0455-5, https://doi.org/10.1016/j.spinee.2009.10.018, https://doi.org/10.1016/j.joca.2012.06.018, https://doi.org/10.2106/00004623-199609000-00003, https://doi.org/10.1148/radiology.164.3.3615879, https://doi.org/10.1016/j.bbrc.2006.02.048, https://doi.org/10.1016/s0736-0266(01)00010-9, https://doi.org/10.1007/s00586-013-2865-7, https://doi.org/10.1016/s0736-4679(97)00243-6, https://doi.org/10.3171/spi.2005.2.1.0011, https://doi.org/10.3760/cma.j.issn.1008-1275.2012.01.008, https://doi.org/10.2214/ajr.162.4.8141015, https://doi.org/10.1016/0021-9290(89)90036-5, https://doi.org/10.1186/s12891-018-2171-y, http://creativecommons.org/licenses/by/4.0/, CircRNA GRB10 is a Novel Biomarker for the Accurate Diagnosis of Lumbar Degenerative Disc Disease. Incorrectly lifting, whether its a heavy box or weights, can damage your spinal discs by placing increased weight on your discs while you move in ways known to be damaging to your discs even when performing normal activities. et al. Make sure that when sitting for long periods, you have proper ergonomic support and when standing, your posture is correct. J. Orthop Sci. Zhang, L. et al. Should they sign up for a weight loss program that is pragmatic and doable? With more than a third of the total US population aged 65 or older1, and with the high prevalence of obesity2, it is relevant to identify any association between these objective demographic factors and the prevalence of spine degeneration. He completed an interventional spine and musculoskeletal fellowship (97). Stenosis can be congenital but is commonly degenerative in origin. Yabuki, S. et al. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the Gold Humanism Honor Society.. That's why as we grow old, our back pains also seem to worsen. If the patient is above ideal body weight, I would recommend weight loss. In some cases, adolescent scoliosis may develop symptoms with aging and require treatment. PubMed https://doi.org/10.1016/j.spinee.2009.10.018 (2010). It may be asymptomatic but is often associated with numbness or tingling. Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: A population-based study. J. Minimally invasive spine surgery techniques have become the mainstream in the past 10 years, particularly as this relates to implant cages and lumbar interbody fusions . Dr. Wolff is highly motivated to help his patients for personal reasons as well. It provides both inpatient and outpatient services and is nationwide in geographic coverage. "The disks of the spine are like shock absorbers in a car," says . Yoganandan et al. The results demonstrate that degenerative findings in the spine are common, and, since asymptomatic individuals may not receive a diagnosis of degenerative conditions, this analysis likely underestimates the general prevalence of these conditions. Inflammation may result when ligaments, tendons, or joints of the spine are acutely injured. Treatment options include disc replacement, other surgical interventions, and nonsurgicaloptions such as acupuncture, back graces and pain management. Arthritis in the low back has similar symptoms and can cause pain in the back and sometimes into the buttocks. BMC Musculoskelet. Hendrix, R. W., Melany, M., Miller, F. & Rogers, L. F. Fracture of the spine in patients with ankylosis due to diffuse skeletal hyperostosis: Clinical and imaging findings. When the pain became too much to bear, he turned to Johns Hopkins. J. Neuroradiol. Pearl completed her internship in Internal Medicine at New England Deaconess Hospital, her residency in Anesthesiology at the Massachusetts General Hospital, and her fellowship in Pain Management at the Brigham and Womens Hospital. Everyones spinal disks degenerate over time and is a normal part of aging. https://doi.org/10.1148/radiology.164.3.3615879 (1987). J. Orthop. Degeneration in the lumbar spine can eventually lead to degenerative spondylolisthesis, which most commonly occurs at L4 on L5, in which the superior vertebral segment slides forward on the inferior segment as a result of the weakened . Degenerative disc disease, despite the name, isn't technically a disease. Oostveen, J. C., Van de Laar, M. A. Google Scholar. https://doi.org/10.1148/15.3.513 (1975). When these disks wear out, people typically experience back pain and stiffness. Kalichman et al. If you or a loved are a young person living with chronic neck or back pain caused by degenerative disc disease, the way you deal with your condition will depend on the severity of your pain as well as whatever is determined from consultation with your doctor. He utilizes the latest in regenerative medicine procedures including: The Discseel Procedure, Platelet Rich Plasma (PRP), Fractionated Fat Mesenchymal Stem Cells (Lipogems) and Pluripotent Amniotic Stem Cells in order to promote a healing process for their patients. Disc degeneration is not a problem most people associate with adolescents and young adults, but it can develop at a young age. The patient does not have a history of trauma. Spine 34(16), 16501657. CP, IC, and AC wrote the main manuscript text and prepared the figures, tables, and Online appendices. Biological sex, with women being more likely to experience symptoms. Kiss, C. S., ONeill, T. W., Mituszova, M., Szilgyi, M. & Por, G. The prevalence of diffuse idiopathic skeletal hyperostosis in a population-based study in Hungary. https://doi.org/10.1093/rheumatology/29.2.131 (1990). When we are born, the disc is about 80percent water. Journal of Neurosurgery: Spine. You may try: Many patients do not need surgery for degenerative disk disease. Table 1 shows the total number of enrollee-years by sex and spine degeneration diagnosis and prevalence by age group. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. You are using a browser version with limited support for CSS. Bone Jt. In some instances where the neck pain is severe and not helped by the other medicine, cortisone pills for one week may be helpful. https://doi.org/10.3233/bmr-2009-0232 (2009). The overall prevalence of diagnosed spinal degenerative disease was 27.3% and increased with age. The results indicate that degenerative spine pathologies may not be diagnosed prior to medical imaging studies being performed. Degenerative disk disease occurs when the cushioning in your spine begins to wear away. He heads international committees responsible for establishing standards and educating surgical and non-surgical physicians. Did you have an injury or accident that led to pain? Res. When arthritis affects the discs (degenerative disc disease), the inner part of the disc - a jelly-like substance called the nucleus pulposis - can dry out as it ages . Osteophytes, or bone spurs, often protrude from the edges of vertebral endplates and sometimes bridge the intervertebral disc space. What is degenerative disc disease? By age 70, most cervical spines show significant degeneration visible on X-rays as well as on MRI imaging, even though few people feel or notice any symptoms. If the physician is concerned that you might have a pinched nerve, then the best tests would be an MRI of the neck or occasionally a computed tomography (CT) scan. Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder characterized by excess bone formation and continuous ossification of soft tissue structures along the anterior and lateral aspects of the spine, generally with preservation of intervertebral disc height and apophyseal joints3. Healthcare service and diagnosis derived from Medicare data can therefore correctly reflect the prevalence of conditions, including spine pathologies, among this population. Pain can affect the low back, buttocks and thighs or the neck, depending on where the affected disc is, radiating to the arms and hands. As the disc dries up, the radial tire part starts to collapse. However, while we all have annular tears, only some of us will experience back pain as a result of them. The sequelae of some degenerative pathologies may be misidentified as acute injuries if the underlying process was not previously identified. Spinal disks are like shock absorbers between the vertebrae, or bones, of your . the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Her Oswestry Disability Index is 50%. Medical billing codes were used to identify concurrent spine degeneration and obesity diagnoses each year. PubMed Central Treating disc degeneration related diseases for years made him strongly believe that minimal invasive procedures benefit the patient as well as the hospital due to their greater efficiency and potential for optimal outcomes and need to be actively promoted. Spine degeneration diagnosis prevalence by type, calendar year, and sex. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. If that does not work, you should contact your doctor for an evaluation and a prescription for stronger medicine. Spine 2, 1116. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Davis, M. S., Isaacs, J. L., Graber, M. A. But is degenerative disc disease a disability? The data set includes Medicare fee-for-service beneficiaries enrolled from January 1, 2005 to December 31, 2017. In 2004, he completed his residency in anesthesiology. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Adult scoliosis may be a case of pediatric scoliosis that was undiscovered until adulthood. https://doi.org/10.1007/s00776-013-0455-5 (2013). https://doi.org/10.1007/s00586-009-0932-x (2009). volume11, Articlenumber:5389 (2021) After age 40, most people experience some spinal degeneration. Get the most important science stories of the day, free in your inbox. PubMed Figure3 shows the prevalence of spine degeneration type for enrollees coded as obese and those not coded as obese. Lumbar Degenerative Disc Disease in a 37-year-old Male Dec 6, 2019 Richard G. Fessler, MD, PhD Professor of Neurosurgery Patient History The patient is a 37-year-old right handed male who underwent L4-L5 microendoscopic discectomy two years ago. We cannot verify that these criteria were consistently applied for all diagnoses in the Medicare database. If the pain is not relieved, then medication can help relieve the symptoms until the pain subsides. PubMed Central Sudden quadriplegia complicating ossification of the posterior longitudinal ligament and diffuse idiopathic skeletal hyperostosis. She has a special interest in sports medicine, pain and spine. In Minimally Invasive Spinal Deformity Surgery (eds Wang, M. et al.) One possible factor is the higher prevalence of osteoporosis in older females compared to males. A comparison of angled sagittal MRI and conventional MRI in the diagnosis of herniated disc and stenosis in the cervical foramen.
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