July 2019 Edition. Volume XIX


This study published in the peer-reviewed journal “Spine” reported on 1,419 patients and pointed out, for the first time, the importance of genomic spine disease.  Juvenile discogenic disease (JDD) was the particular genomic entity reported on,.  Since this study was published it has become apparent that with better imaging and with better awareness on the part of clinicians, that as many as 40% of all  patients presenting with significant back complaints have JDD or related genomic disorders.  Unless identified and effectively blocked by appropriate preventive programs those with these problems are at high risk for subsequent disability.  It has been estimated, by some spine surgeons, that about 80% of patients coming to surgery (frequently multiple surgeries) have previously unrecognized and untreated underlying genomic disorders. The Burton Experience confirms this observation.

KBHperuKenneth Heithoff, founder of the Center for Diagnostic Imaging in Minneapolis, was one
of the first radiologists in the United States to apply CT and MRI imaging in the diagnosis of genomic spine disorders.  Heithoff and his associates were the radiologic pioneers who first brought the awareness of disease entities such as JDD to the attention of the medical establishment.
Heithoff, who has published numerous radiologic survey studies, has documented the association of  JDD, as a congenital abnormality of development, with other congenital abnormalities.  This is a typical example of the “Zebra Phenomenon.”

These have included the following:

Congenitally Small Spinal Canal
Congenital Poor Support
Tropism of the Facet Joints
Asymmetrical Vertebrae
Spina Bifida
Conjoined Nerve Roots

In 1997 Heithoff and his associates, at the Center for Diagnostic Imaging in Minneapolis, noted that “Early recognition with prompt institution of conservative therapy and vocational counseling may be important in these patients to avoid, or at least delay, the complications of degenerative disc disease” (Gundry C, Fritts H: Juvenile Discogenic Disease, Clin. Ortho. Rel. Res., Number 343, 1997).

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