Coronal and sagittal spinal alignment in lumbar disc herniation with scoliosis and trunk shift

Abstract

Background To investigate the incidence of scoliosis and trunk shift in patients with LDH (lumbar disc herniation) and analyze the differences in spinopelvic alignment among patients with or without trunk shift and non-symptom controls. Materials and methods All included subjects had standard upright antero-posterior and lateral radiographs of the whole spine taken. Evidence of disc herniation was confirmed by computed tomography or magnetic resonance imaging. The parameters measured included trunk shift and Cobb angle, TK (thoracic kyphosis), TLK (thoraco-lumbar junction kyphosis), LL (lumbar lordosis), PI (pelvic incidence), SS (sacral slope), PT (pelvic tilt) and SVA (sagittal vertical axis). Results Sixty-eight patients with LDH and 61 controls were included. There were significantly more male patients with trunk shift than the patients without trunk shift. Forty-two patients had curve magnitudes ranging from 5 to 38°. The trunk shift ranged from 0.5 to 7.3 cm. A total of 54.76% of patients had a disc herniation on the concave side of the main curve. Fifty percent of patients showed a trunk shift towards the opposite side of disc herniation. There were significant differences in spinopelvic parameters among groups. Significant correlations were also observed between several spinopelvic parameters in the three groups. However, the degrees of correlations among the spinopelvic parameters differed among the three groups. Conclusion Spinal sagittal morphology in LDH patients with trunk shift exhibits a more anterior shift of the C7 plumb line, less LL, and a more horizontal sacrum. Correlation analysis indicated a disharmonious spinopelvic interaction and a change in the compensatory model in patients with LDH.

Fast Independent Component Analysis Algorithm-Based Diagnosis of L5 Nerve Root Compression and Changes of Brain Functional Areas Using 3D Functional Magnetic Resonance Imaging

“…e results suggested that the FA of L3 and L4 lumbar nerve roots in the subjects of group A were not statistically extreme compared with that of group B (P > 0.05), which was similar to the research results of Wang et al [17], indicating that patients with L5 nerve root pain caused by LDH had no lesion changes in L3 and L4 lumbar nerve roots, which were not different from healthy volunteers. e FA of L5 and S1 lumbar nerve roots was lower steeply in the subjects of group A than that of group B, and the difference has statistical significance (P < 0.05), which was different from the results of Wu et al [18]. It might be associated with histopathological changes in nerve roots generated from the nerve root compressed by herniated disc, and DTI images presented the disorder and narrow of nerve fibers and the decline of FA.…”

<p>Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases</p>

“…Parameters of spinal kyphosis (TK), the C7 plumb line (PL), and the sagittal vertical axis (SVA) from C7 PL were associated with the biomechanical characteristics of discs. 51 Regrettably, it was difficult to perform further research using these data because of the lack of related preoperative examination. This lack of data is an inherent limitation of retrospective studies.…”

Sciatica-Related Spinal Imbalance in Lumbar Disc Herniation Patients: Radiological Characteristics and Recovery Following Endoscopic Discectomy

“…The changes of lumbosacral parameters could also be observed in LDH patients and compensatory mechanisms of spinal sagittal imbalance mainly include more forward translation of SVA, LL loss, TK and PT increase. 2,8,16,17,19,20 In the current study, the magnitude of spinal imbalance was different among the three subgroups. The magnitude of sagittal and coronal imbalance in Group C was significantly more severe than that of Group A and Group B.…”

“…Because L4-5 was not confined to the pelvic cavity, it may be more vulnerable to trunk list compared with L5-S1. As for whether the gender is the risk factor for the trunk shift in LDH, sciatic scoliosis was more frequently observed in men 2,7 than in women 17 in previous reports. In our study, the gender and affected level were not found to be related to spinal imbalance.…”

“…Lumbar disc herniation (LDH) is an increasingly common disease in the world, and sciatica is the most common related symptom. [1][2][3] Based on population studies, the incidence of symptomatic LDH accounts for an appropriate 1% of the general population. 4 The main symptoms of most LDH patients are low back pain with sciatica and difficulty in walking.…”