Sharma A, et al. – This study was meant to evaluate the differences in the temporal evolution of disc in segments of the lumbar spine with and without signs of increased mechanical stresses. At baseline, stressed discs exhibited a higher burden of nuclear and annular degeneration. Irrespective of improvement or worsening of stress–related bony changes, these discs had a higher risk of progressive nuclear degeneration.

• For this study, two radiologists assessed lumbar intervertebral discs for degenerative changes affecting the annulus fibrosus, the nucleus pulposus, and the endplates in 42 patients (22 male, 20 female; mean age, 16.0 ± 3.7 years [range, 7-25 years]) with low back pain and imaging evidence of stress reaction/fracture in the lumbar spine using MR imaging performed >6 months apart.
• In stressed vs. nonstressed segments, data were examined for differences in the presence and progression of disc degeneration.

• Stressed discs had a higher burden of annular fissures, radial fissures, herniation, and nuclear degeneration at baseline.
• In stressed and control discs, endplate defect burden was similar.
• For stressed and control discs, the burden of new annular fissures and endplate defects was comparable at follow-up.
• A higher proportion of stressed discs, however, demonstrated worsening nuclear signal intensity grade (14.3% vs. 0% control discs; P = .008) and worsening nuclear degeneration grade (11.9% vs. 0% control discs; P = .02).
• They observed an increased risk of progressive nuclear degeneration of stressed discs irrespective of the outcome of bony changes.