Lumbosacral morphology in lumbar disc herniation: a "chicken and egg" issue

Objective: The aim of this study was to analyze the relationship, if any, between lumbar disc herniation and lumbosacral morphology.Methods: Intervertebral disc angles (IDA), lumbar lordosis angle (LLA), lumbosacral lordosis angle (LSLA), lumbosacral angle (LSA), and sacral tilt (ST) were measured on lumbar magnetic resonance imaging of 224 patients with LDH (n=151) and without LDH (n=73) and were then compared.Results: Regarding LLA, LSLA, LSA and ST, there were no significant differences between the 2 groups. The smallest IDA of each level (except L2-L3) was detected at the same level with disc herniation. When the relationship between the grade of disc herniation and IDA was evaluated in patients with LDH, angles of L3-L4 and L4-L5 levels were significantly smaller in patients with extruded disc herniation (p=0.009 and p=0.013, respectively).Conclusion: Despite changes in IDA by grade and level of disc herniation, no relation was found between lumbosacral alignment and LDH.

___

Antoniades SB, Hammerberg KW, DeWald RL. Sagit- tal plane configuration of the sacrum in spondylolisthesis. Spine (Phila Pa 1976) 2000;25:1085-91.

Belavy DL, Armbrecht G, Felsenberg D. Evaluation of lum- bar disc and spine morphology: long-term repeatability and comparison of methods. Physiol Meas 2012;33:1313-21.

Chaléat-Valayer E, Mac-Thiong JM, Paquet J, Berthon- naud E, Siani F, Roussouly P. Sagittal spino-pelvic align- ment in chronic low back pain. Eur Spine J 2011;20 Suppl 5:634-40.

Chen IR, Wei TS. Disc height and lumbar index as in- dependent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Spine (Phila Pa 1976) 2009;34:1402-9.

Damasceno LHF, Catarin SRG, Campos AD, Defino HLA. Lumbar lordosis: A study of angle values and of ver- tebral bodies and intervertebral discs role. Acta Ortop Bras 2006;14:193-8.

Evcik D, Yücel A. Lumbar lordosis in acute and chronic low back pain patients. Rheumatol Int 2003;23:163-5.

Jackson RP, McManus AC. Radiographic analysis of sagit- tal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine (Phila Pa 1976) 1994;19:1611-8.

Endo K, Suzuki H, Tanaka H, Kang Y, Yamamoto K. Sag- ittal spinal alignment in patients with lumbar disc hernia- tion. Eur Spine J 2010;19:435-8.

Ergün T, Lakadamyalı H, Sahin MS. The relation between sagittal morphology of the lumbosacral spine and the de- gree of lumbar intervertebral disc degeneration. Acta Or- thop Traumatol Turc 2010;44:293-9.

Rajnics P, Templier A, Skalli W, Lavaste F, Illes T. The im- portance of spinopelvic parameters in patients with lumbar disc lesions. Int Orthop 2002;26:104-8.

Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 1994;331:69-73.

De Carvalho DE, Callaghan JP. Influence of automobile seat lumbar support prominence on spine and pelvic postures: a radiological investigation. Appl Ergon 2012;43:876-82.

De Carvalho DE, Soave D, Ross K, Callaghan JP. Lumbar spine and pelvic posture between standing and sitting: a radiologic investigation including reliability and repeatabil- ity of the lumbar lordosis measure. J Manipulative Physiol Ther 2010;33:48-55.

Roussouly P, Gollogly S, Berthonnaud E, Dimnet J. Clas- sification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing posi- tion. Spine (Phila Pa 1976) 2005;30:346-53.

Barrey C, Jund J, Noseda O, Roussouly P. Sagittal bal- ance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 2007;16:1459-67.

Youdas JW, Garrett TR, Egan KS, Therneau TM. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Phys Ther 2000;80:261-75.

Bierma-Zeinstra SM, van Gool JJ, Bernsen RM, Njoo KH. Measuring the sacral inclination angle in clinical practice: is there an alternative to radiographs? J Manipulative Physiol Ther 2001;24:505-8.

Harrington J Jr, Sungarian A, Rogg J, Makker VJ, Ep- stein MH. The relation between vertebral endplate shape and lumbar disc herniations. Spine (Phila Pa 1976) 2001;26:2133-8.

Pappou IP, Cammisa FP Jr, Girardi FP. Correlation of end plate shape on MRI and disc degeneration in surgically treated patients with degenerative disc disease and herni- ated nucleus pulposus. Spine J 2007;7:32-8.

He X, Liang A, Gao W, Peng Y, Zhang L, Liang G, Huang D. The relationship between concave angle of vertebral endplate and lumbar intervertebral disc degeneration. Spine (Phila Pa 1976) 2012;37:E1068-73.

Been E, Li L, Hunter DJ, Kalichman L. Geometry of the vertebral bodies and the intervertebral discs in lumbar seg- ments adjacent to spondylolysis and spondylolisthesis: pi- lot study. Eur Spine J 2011;20:1159-65.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

Correction of pincer nail deformity with dermal flap: a new technique in pincer nail deformity surgery

SERDAR ALTUN, MURAT GÜRGER, Enver ARPACI, EMRE İNÖZÜ

Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting: results of 7.6-year follow-up

MEHMET BEKİR ÜNAL, Eren CANSÜ, Fatih PARMAKSIZOĞLU, Hakan ÇİFT, Serkan GÜRCAN

Lumbosacral morphology in lumbar disc herniation: a "chicken and egg" issue

İLKE COŞKUN BENLİDAYI, SİBEL BAŞARAN, Gülşah ŞEYDAOĞLU

Partial matricectomy with cryotherapy in treatment of ingrown toenails

Ahmet YILMAZ, Erol ÇENESİZOĞLU

The effect of training on fracture clinic efficiency and patient access

Gavin John HEYES, Jim MCCONWAY

Postoperative pain in total hip arthroplasty

Memduh YETIM, Şükrü TEKİNDUR, Oğuz KILIÇKAYA

Impact of platelet-rich plasma injection timing on healing of Achilles tendon injury in a rat model

Esra CİRCİ, Yunus Emre AKMAN, Erhan ŞÜKÜR, Erol Rüştü BOZKURT, Tolga TÜZÜNER, YUSUF ÖZTÜRKMEN

Intralesional application of epidermal growth factor in limb-threatening ischemic diabetic foot ulcers

ŞAMİL AKTAŞ, Selçuk BAKTIROĞLU, Levent DEMİR, ÖNDER İSMET KILIÇOĞLU, Murat TOPALAN, Erdem GÜVEN, BENGÜSU MİRASOĞLU, Fatih YANAR

Location change of center of rotation after single-level cervical total disc replacement with ProDisc-C

Jigang LOU, Huibo LI, Xin RONG, Wenjie WU, Hao LIU

The effect of simple local resection on pain and scoliotic curve in patients with scoliosis secondary to osteoid osteoma and osteoblastoma in the spine

Mehmet BÜLENT BALIOGLU, Akif ALBAYRAK, Yunus ATICI, Sami SÖKÜCÜ, Mehmet Temel TACAL, Mehmet Akif KAYGUSUZ