Degenerative Spine Disease and Cancer: Is there a Link? - Abstract
Objective: Within our radiology department, we anecdotally observed that patients over the age of 65 with cancer demonstrated significantly less degenerative disease of the spine (DDD) compared to patients without cancer when reviewing CT scans of the abdomen and pelvis. The objective of this study is to determine if a statistical correlation exists between cancer and DDD. Materials and Methods: A list of subjects with CT scans of the abdomen and pelvis between January 1, 2014 and February 28, 2016 was compiled for retrospective review. Test subjects with known cancer were selected from our institution’s Tumor Board Registry and control subjects without a diagnosis of cancer were selected chronologically from our PACS system. After vetting for inclusion and exclusion criteria, the CT scans were anonymized and reviewed by three radiologists who subjectively evaluated degenerative changes of the anterior column, facet joints, and sacroiliac joints using a 4-point severity scale. Subjects were subdivided into 40-49, 50-59, 60-69, and 70-79years old age groups for comparison purposes.
Results: Out of 164 test subjects (with cancer) and 421control subjects (without cancer), 75 test subjects and 90 control subjects satisfied the inclusion and exclusion criteria. With increasing age, the overall incidence and severity of DDD was less in the test group compared to the control group. The 70-79years-old test group demonstrated a 37% lower overall degenerative disease severity score in the anterior column compared to the control group. Overall intraobserver reliability was 84%. Conclusions: The results support our observation that there is a significant difference in DDD in cancer patients compared to non-cancer patients. With further research and investigation, an underlying factor associated with the generation or of degenerative changes may be discovered and exploited to prevent or treat cancer.