{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T05:28:48Z","timestamp":1791091728792,"version":"4.1.0"},"reference-count":61,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2010,4,19]],"date-time":"2010-04-19T00:00:00Z","timestamp":1271635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Typically, age and abnormal physical loading (\u201cwear and tear\u201d) have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, \u201cskipped\u201d level (nonconsecutive) disc degeneration (SLDD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>As part of a large genetics\u2010based study in southern Chinese individuals (n = 1,989), a cross\u2010sectional analysis was performed in subjects exhibiting disc degeneration in \u22652 levels (n = 838) who were then categorized as having SLDD (n = 174) or non\u2010SLDD (contiguous, multilevel; n = 664). Various radiographic parameters were assessed based on T2\u2010weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 8.7% of the whole population (n = 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n = 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04\u20132.10, <jats:italic>P<\/jats:italic> = 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78\u20134.15, <jats:italic>P<\/jats:italic> &lt; 0.001), which also presented in levels with no disc degeneration. A history of disc bulge\/extrusion (<jats:italic>P<\/jats:italic> = 0.004) and\/or a history of back injury (<jats:italic>P<\/jats:italic> = 0.010) was significantly associated with non\u2010SLDD, and a greater degree of overall severity of disc degeneration was also associated with non\u2010SLDD. Other demographic and MRI findings did not significantly differ between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.27523","type":"journal-article","created":{"date-parts":[[2010,4,19]],"date-time":"2010-04-19T16:58:14Z","timestamp":1271696294000},"page":"2392-2400","source":"Crossref","is-referenced-by-count":47,"title":["Intervertebral disc degeneration: New insights based on \u201cskipped\u201d level disc pathology"],"prefix":"10.1002","volume":"62","author":[{"given":"Kenneth M. C.","family":"Cheung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dino","family":"Samartzis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaro","family":"Karppinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence P. S.","family":"Mok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W. H.","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Y. T.","family":"Fong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith D. K.","family":"Luk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,8,3]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200007010-00005"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200212010-00002"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199712150-00001"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000146461.27105.2b"},{"key":"e_1_2_7_6_2","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1097\/00007632-199008010-00002","article-title":"1990 Volvo Award in clinical sciences: lumbar spinal pathology in cadaveric material in relation to history of back pain, occupation, and physical loading","volume":"15","author":"Videman T","year":"1990","journal-title":"Spine"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198802000-00008"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181573b87"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000214889.31505.08"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.971"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0362-6"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199707150-00023"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathophys.2007.12.001"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199109000-00001"},{"key":"e_1_2_7_15_2","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.1097\/00007632-199512150-00001","article-title":"1995 Volvo Award in clinical sciences: determinants of lumbar disc degeneration. A study relating lifetime exposures and magnetic resonance imaging findings in identical twins","volume":"20","author":"Battie MC","year":"1995","journal-title":"Spine"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.07.392"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-0171-3"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000216530.41838.d3"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000190828.85331.ef"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2007.12.017"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2350-9-38"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2006.047076"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199902)42:2<366::AID-ANR20>3.0.CO;2-6"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)01312-4"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198704000-00013"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199501000-00003"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.10.005"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000171911.99348.90"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2008.04.005"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000146457.83240.eb"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1957.01280130081014"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199007000-00012"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-9-51"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.3109\/ort.1972.43.suppl-142.01"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2142"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198704000-00016"},{"key":"e_1_2_7_37_2","volume-title":"Clinical biomechanics of the spine","author":"White AA","year":"1990"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200012010-00011"},{"key":"e_1_2_7_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-200010000-00013"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(01)00006-7"},{"key":"e_1_2_7_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1350-4533(01)00076-5"},{"key":"e_1_2_7_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-003-0675-1"},{"key":"e_1_2_7_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817bb956"},{"key":"e_1_2_7_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0515-7"},{"key":"e_1_2_7_45_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817b8fed"},{"key":"e_1_2_7_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000260795.57798.a0"},{"key":"e_1_2_7_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.22789"},{"key":"e_1_2_7_48_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.038224"},{"key":"e_1_2_7_49_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.057166"},{"key":"e_1_2_7_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199611150-00001"},{"key":"e_1_2_7_51_2","first-page":"113","article-title":"Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro","volume":"120","author":"Maroudas A","year":"1975","journal-title":"J Anat"},{"key":"e_1_2_7_52_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199503150-00006"},{"key":"e_1_2_7_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-008-0645-6"},{"key":"e_1_2_7_54_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.76B5.8083266"},{"key":"e_1_2_7_55_2","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1302\/0301-620X.63B4.6457838","article-title":"Clinical studies of isolated disc resorption in the lumbar spine","volume":"63","author":"Venner RM","year":"1981","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_7_56_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199402001-00012"},{"key":"e_1_2_7_57_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000150833.93248.09"},{"key":"e_1_2_7_58_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31815a59a0"},{"key":"e_1_2_7_59_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.152.1.6729099"},{"key":"e_1_2_7_60_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200109010-00011"},{"key":"e_1_2_7_61_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199005000-00012"},{"key":"e_1_2_7_62_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2005.031040.x"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.27523","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.27523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T20:53:06Z","timestamp":1698785586000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.27523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,8]]},"references-count":61,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2010,8]]}},"alternative-id":["10.1002\/art.27523"],"URL":"https:\/\/doi.org\/10.1002\/art.27523","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,8]]}}}