Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation.
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BORIS DOI
Publisher DOI
PubMed ID
34300340
Description
BACKGROUND
The aim of this study was to determine whether the presence of disproportionate vertebral bodies is a risk factor for disc herniation (DH).
METHODS
Sixty-seven consecutive patients (m: 31 f: 36) who underwent lumbar discectomy for symptomatic DH at one level between L3 and S1 were retrospectively included. The last three motion segments (3 × 67 = 201) were assessed on sagittal MRI scans. A disproportionate motion segment was defined as the difference of more than 10% of the antero-posterior diameter of two adjacent endplates.
RESULTS
DH was present in 6/67 (9%), 26/67 (38.8%), and 35/67 (52.2%) patients at L3/4, L4/5, and L5/S1, respectively. A total of 14 of 67 patients demonstrated a disproportionate motion segment at the discectomy level (20.9%). A total of 23 of the 201 (11.4%) investigated motion segments met our criteria for a disproportionate motion segment. In our study population, when one of the 201 segments was disproportionate, the positive predictive value (PPV) for DH increased toward the lower segments: the PPV at the L5/S1 level was 83.0%. The odds ratio of disproportion for DH was the highest at the L5/S1 level, with 6.0 ± 0.82 (p = 0.017).
CONCLUSIONS
The presence of a disproportionate motion segment in the lower spine may lead to a significant higher risk for DH in patients undergoing discectomy.
The aim of this study was to determine whether the presence of disproportionate vertebral bodies is a risk factor for disc herniation (DH).
METHODS
Sixty-seven consecutive patients (m: 31 f: 36) who underwent lumbar discectomy for symptomatic DH at one level between L3 and S1 were retrospectively included. The last three motion segments (3 × 67 = 201) were assessed on sagittal MRI scans. A disproportionate motion segment was defined as the difference of more than 10% of the antero-posterior diameter of two adjacent endplates.
RESULTS
DH was present in 6/67 (9%), 26/67 (38.8%), and 35/67 (52.2%) patients at L3/4, L4/5, and L5/S1, respectively. A total of 14 of 67 patients demonstrated a disproportionate motion segment at the discectomy level (20.9%). A total of 23 of the 201 (11.4%) investigated motion segments met our criteria for a disproportionate motion segment. In our study population, when one of the 201 segments was disproportionate, the positive predictive value (PPV) for DH increased toward the lower segments: the PPV at the L5/S1 level was 83.0%. The odds ratio of disproportion for DH was the highest at the L5/S1 level, with 6.0 ± 0.82 (p = 0.017).
CONCLUSIONS
The presence of a disproportionate motion segment in the lower spine may lead to a significant higher risk for DH in patients undergoing discectomy.
Date of Publication
2021-07-19
Publication Type
Article
Subject(s)
Keyword(s)
anatomy disc herniation disproportional spine disproportionate motion segment hypoplastic vertebral body lumbar spine
Language(s)
en
Contributor(s)
Läubli, Ralph | |
Brugger, Robin | |
Pirvu, Tatiana | |
Sieroń, Dominik | |
Szyluk, Karol |
Series
Journal of clinical medicine
Publisher
MDPI
ISSN
2077-0383
Access(Rights)
open.access