Association Between Lumbar Spine Sagittal Alignment and L4-L5 Disc Degeneration Among Asymptomatic Young Adults

Reis, Rafael de Menezes; Bonugli, Gustavo Perazzoli; Dalto, Vitor Faeda; Herrero, Carlos Fernando Pereira da Silva; Defino, Helton Luíz Aparecido; Nogueira-Barbosa, Marcello Henrique

doi:10.1097/brs.0000000000001568

Cited by 38 publications

(54 citation statements)

References 20 publications

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“…In 2016, Rafael et al identified moderate associations between the spinopelvic parameters and disc degeneration in type II spine among asymptomatic people [9]. In our study, we only identified slightly negative correlations between the LL and disc degeneration grade at L4-L5 in groups B and C (Table 4).…”

Section: Discussionsupporting

confidence: 46%

“…Lumbar intervertebral disc degeneration (LDD), the main cause of lumbar spinal disorders, is associated with biomechanical stresses and increases with age [1][2][3][4][5][6]. Previous studies have demonstrated that sagittal spinopelvic alignment plays an important role in LDD [7][8][9]. Therefore, it is meaningful and useful to study the relationship between spinal sagittal morphology and disc degeneration.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have evaluated the association between spinal sagittal morphology and LDD [9,14]. Rafael et al [9], for example, found that Roussouly type II sagittal alignment is significantly associated with early disc degeneration at the L4-L5 level, compared with type IV. However, Torrie et al [14] proposed that lumbar sagittal subtypes were not statistically significantly correlated with LDD.…”

Section: Introductionmentioning

confidence: 99%

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Different spinal subtypes with varying characteristics of lumbar disc degeneration at specific level with age: a study based on an asymptomatic population

Chen¹,

Li²,

Huang³

et al. 2020

J Orthop Surg Res

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Background: The relationship between spinal sagittal subtypes and lumbar disc degeneration is unclear. Thus, we aimed to investigate the relationship between lumbar intervertebral disc degeneration and age in asymptomatic healthy individuals with different sagittal alignments. Methods: In this cross-sectional observational study, we examined 209 asymptomatic young and middle-aged volunteers (123 women and 86 men) who were divided into the following three groups according to age: groups A (20-30 years), B (31-40 years), and C (41-50 years). The volunteers underwent full-spine standing lateral radiography and magnetic resonance imaging (MRI, 3.0 T) of the lumbar spine. Based on panoramic radiography, two observers measured the spinopelvic parameters and classified the spine into Roussouly subtypes. The degree of disc degeneration was assessed based on T2-weighted images according to the Pfirrmann classification. Results: There was a statistically significant difference in the degree of degeneration of type I spine between groups B and C at L4-L5 (P < 0.03) and L5-S1 (P < 0.01) and between groups A and C at L1-L2 (P < 0.04) and L4-L5 (P < 0.01). The degeneration degree of type II spine at all levels were significantly different between groups A and C. No statistically significant difference was found between groups A and B in all subtypes except for type II spine at L1-L2 (P < 0.04). A significant difference was found at four levels between groups B and C in type III spine (P < 0.05) and between groups A and C. For type IV spine, there was a significant difference in the degree of degeneration at L4-L5 (P < 0.02) between groups A and C. Moreover, almost all single parameters were not strongly correlated with the degree of disc degeneration. Conclusion: The different spinal subtypes have characteristics of lumbar disc degeneration at specific levels with age. We considered that spinal classification could be used as a predictor of lumbar disc degeneration. Our data may be helpful to increase awareness of the relationship between spinal subtypes and lumbar disc degeneration.

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Section: Discussionsupporting

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Different spinal subtypes with varying characteristics of lumbar disc degeneration at specific level with age: a study based on an asymptomatic population

Chen¹,

Li²,

Huang³

et al. 2020

J Orthop Surg Res

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“…A critical PI value was noted; whereby, a PI of 42 or lower exhibited a fourfold increased risk in the development of these phenotypes, this 42 was determined from ROC analyses. Several studies have investigated spinopelvic alignment in patients having certain signs of disc degeneration, 38 lumbar disc displacement, 39 and spondylolisthesis. 17 However, and in particular, excluding cases of spondylolisthesis and having a more robust definition of disc degeneration in our study, we noted the novel finding that PI was significantly related to MCs, UDS as well as lumbar disc displacement and the combination of the three phenotypes.…”

Section: Discussionmentioning

confidence: 99%

Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes

et al. 2020

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Lumbar disc‐displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc‐displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in various spinal disorders. Pelvic incidence (PI) is “fixed parameter” since skeletal maturity. No study has addressed disc‐displacement, MCs and UDS in context of spinopelvic parameters. Therefore, the aim of study was to determine if spinopelvic parameters are associated and predict clinically‐relevant MRI‐phenotypes. One hundred and eight population‐based subjects (mean age: 52.3 years) were recruited. Spondylolisthesis and scoliosis individuals were excluded. Lumbar lordosis (LL), PI, sacral slope (SS), and pelvic tilt (PT) were assessed on lateral plain radiographs. Disc degeneration was assessed and summated, and presence or not of disc‐displacement and MCs were noted on T2W MRI. UDS was detected on UTE. Following exclusion criteria, 95 subjects were assessed. Disc‐displacement (82.1%), MCs (52.6%), and UDS (37.9%) were associated with lower PI, SS, LL, and LL/PI index. On multivariate analyses, lower PI was significantly related to development of these MRI phenotypes (adjusted OR range:0.95‐0.92; P < .05), with critical PI value of 42° or lower exhibiting fourfold increase risk of combined phenotypes (P = .020). Of UDS discs, 39.3% had adjacent MCs and 83.6% had disc‐displacement. 87.5% of MC had directly adjacent UDS. The first study to note that PI may “predict” the development of disc‐displacement, MCs and UDS, suggesting potential sub‐variants and mechanistic susceptibility that may be grounded in spinopelvic evolution. An “evolutionary etiological pathway” of spinal phenotype development is proposed.

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“…It is crucial to maintain proper upright posture be inferred that patients with a high L 4-5 I will show a high LL and correlate with our result. Consequently, with an increase in lordosis, there will be increased loading to the posterior complex of the lumbosacral spine, which can be a major cause of spondylolysis (5, 24,28,29,39). In addition, this may induce the development of spondylolisthesis because of a high L 4-5 S (5,7,8).…”

Section: Statisticsmentioning

confidence: 99%

Determination of spinopelvic parameters in degenerative lumbar spondylolisthesis patients undergoing lumbosacral spine fusion surgery: the lesson learnt

Chumnanvej

Segkhaphant²

2018

Turkish Neurosurgery

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be elucidated (1,7,33). Thus, the objective parameters such as spinopelvic parameters are required (9,11,29). Since spinopelvic parameters are intricately associated with the deformity, changes in spinopelvic parameters can be objectively determined after correction of the deformity (10,17,23,25,28,38). Several studies have proposed methods for determination of spinopelvic parameters after surgical correction for DLS (2-5,

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Association Between Lumbar Spine Sagittal Alignment and L4-L5 Disc Degeneration Among Asymptomatic Young Adults

Abstract: 3.

Cited by 38 publications

References 20 publications

Different spinal subtypes with varying characteristics of lumbar disc degeneration at specific level with age: a study based on an asymptomatic population

Different spinal subtypes with varying characteristics of lumbar disc degeneration at specific level with age: a study based on an asymptomatic population

Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes

Determination of spinopelvic parameters in degenerative lumbar spondylolisthesis patients undergoing lumbosacral spine fusion surgery: the lesson learnt

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