Introducing a New Risk Factor for Lumbar Disc Herniation in Females : Vertical Angle of the Sacral Curvature

Kanat, Ayhan; Yazar, Uğur; Kazdal, Hızır; Sönmez, Osman Fikret

doi:10.3340/jkns.2012.52.5.447

Cited by 26 publications

(35 citation statements)

References 17 publications

(19 reference statements)

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“…The lumbosacral structure is also a major factor in IDD [ 10 , 11 ]. The present study did not identify a correlation between STA and SKA or between these factors and age, number of deliveries, or any other variable.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Imaging Evaluation of L5-S1 Intervertebral Disc Degeneration in Japanese Women

et al. 2014

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Study DesignRetrospective case series.PurposeTo calculate the prevalence of L5-S1 intervertebral disc degeneration (IDD) by evaluating gynecological disease findings, obtained by pelvic magnetic resonance imaging (MRI), and reveal the risk factors for IDD by analyzing its relationship with age, sacral structure, body mass index (BMI), number of deliveries, and intrapelvic space-occupying lesions.Overview of LiteratureAge, obesity, height, smoking history, occupation, and lumbosacral structure are reportedly the main factors of lumbar IDD. However, in women, the relationship of IDD with obstetric and gynecological history is unclear.MethodsThe presence of L5-S1 IDD was evaluated on sagittal T2-weighted pelvic MRI during gynecological evaluations in 660 Japanese women. We measured the sacral table angle (STA), sacral kyphosis angle (SKA), and intrapelvic space-occupying lesion size. Age, height, weight, BMI, number of deliveries, lumbosacral structure, size of space-occupying lesions, and presence of uterine leiomyoma based on medical records were compared between the IDD-positive and IDD-negative groups.ResultsLumbosacral IDD was observed in 405 cases (61.4%), and its prevalence increased with age. Differences in age, height, weight, BMI, and number of deliveries between the IDD-positive and -negative groups were significant, but differences in STA, SKA, and presence of uterine leiomyoma and space-occupying lesion size were not. Logistic regression analysis indicated that age, BMI, and STA were risk factors for lumbosacral IDD.ConclusionsAge is the biggest risk factor for lumbosacral IDD in Japanese women, with BMI and STA also contributing to its development. However, SKA and obstetric and gynecological history were not significantly involved.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have indicated a relationship between IDD and lumbosacropelvic structure [ 10 , 11 ]. The degree of intervertebral disc degeneration increased in parallel with a decrease in the sacral kyphosis angle and with the increase in the sacral table angle [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Evaluation of L5-S1 Intervertebral Disc Degeneration in Japanese Women

et al. 2014

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“…Other cases have less curvature, affecting only the lower third of the body. 17 It is unclear whether the degrees of vertical angles of sacral curvature are the same for all adult patients with disc herniation. Some authors analyzed this angle and compared the results in patients without any lumbar disc disease, 17 introducing the new risk factor.…”

Section: Introductionmentioning

confidence: 99%

“… 17 It is unclear whether the degrees of vertical angles of sacral curvature are the same for all adult patients with disc herniation. Some authors analyzed this angle and compared the results in patients without any lumbar disc disease, 17 introducing the new risk factor. In our work experience, we felt that the angle of the sacral in some patients with degenerative lesions require surgery varied by ordinary people.…”

Section: Introductionmentioning

confidence: 99%

The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration

et al. 2016

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The purpose of this study is to determine the reliability and validity of a goniometric measurement of the vertical angle of the sacrum and sacral angle (SA), and their relationships to lumbar degeneration.A herniated lumbar disc is one of the most frequent medical issues. Investigators in a number of studies have reported associated risk factors for prevalent disc degeneration. Atypical lumbosacral angles and curvature are thought to contribute to the degradation of the spine by many researchers. This study analyzed 360 patients referred to our clinic from 2013 to 2015 due to low back pain. A cross-sectional case–control study was designed in order to compare the sagittal alignment of the lumbosacral area in 3 groups of patients suffering from LBP. A total 120 patients were in a control group with a normal lumbar magnetic resonance imaging (MRI), 120 patients had lumbar disk herniation (LDH), and 120 patients had spinal stenosis. From the sagittal plan of lumbar MRI, SA and vertical angle of sacral curvature (VASC) were determined and then analyzed.The means of VASC in these groups were: 38.98 (SD: 6.36 ± 0.58), 40.89 (SD: 7.69 ± 0.69), and 40.54 (SD: 7.13 ± 0.92), respectively (P = 0.089). Moreover, studies of SA in 3 groups showed that the means of SA were: 39.30 (SD: 6.69 ± 0.63), 40.52 (SD: 7.47 ± 0.65), and 35.63 (SD: 6.07 ± 0.79), respectively. Relation between SA and spinal stenosis was just statistically significant (P ≤ 0.05).One significant limitation of our study is the lack of standing MRI for increased accuracy of measurement. However, we were reluctant to give patients needless exposure to radiation from conventional X-ray, and instead used MRI scans. We did not find any significant correlation between the VASC and LDH in lumbar MRI. Also, SA is not an independent risk factor for LDH in men and women. We suggested that there are several biomechanical factors involved in LDH.

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“…For decades, lumbar discectomy has been one of the most common surgical practices performed by neurosurgeons. [ 4 5 ] Cauda equina syndrome (CES) is a serious neurologic disorder of lumbar disc herniation. [ 6 ] Back pain and radiculopathy are the most common symptoms.…”

Section: Introductionmentioning

confidence: 99%

Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness

Akça

Özdemi̇r

Kanat

et al. 2014

J Craniovert Jun Spine

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Context:Little seems to be known about the sexual dysfunction (SD) in lumbar intervertebral disc herniation.Aims:Investigation of sexual and sphincter dysfunction in patient with lumbar disc hernitions.Settings and Design:A retrospective analysis.Materials and Methods:Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September 2012-March 2014.Statistical Analysis Used:Statistical analysis was performed using the Predictive Analytics SoftWare (PASW) Statistics 18.0 for Windows (Statistical Package for the Social Sciences, SPSS Inc., Chicago, Illinois). The statistical significance was set at P < 0.05. The Wilcoxon signed ranks test was used to evaluate the difference between patients.Results:Four patients with sexual and sphincter dysfunction were found, including two women and two men, aged between 20 and 52 years. All of them admitted without low back pain. In addition, on neurological examination, reflex and motor deficit were not found. However, almost all patients had perianal sensory deficit and sexual and sphincter dysfunction. Magnetic resonance imaging (MRI) of three patients displayed a large extruded disc fragment at L5-S1 level on the left side. In fourth patient, there were not prominent disc herniations. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. A syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease.Conclusion:A syndrome with perianal sensory deficit, paralysis of the sphincter, and sexual dysfunction may occur in patients with lumbar L5-S1 disc disease. The improvement of perianal sensory deficit after surgery was counteracted by a trend toward disturbed sexual function. Further researches are needed to explore the extent of this problem.

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Introducing a New Risk Factor for Lumbar Disc Herniation in Females : Vertical Angle of the Sacral Curvature

Cited by 26 publications

References 17 publications

Magnetic Resonance Imaging Evaluation of L5-S1 Intervertebral Disc Degeneration in Japanese Women

Magnetic Resonance Imaging Evaluation of L5-S1 Intervertebral Disc Degeneration in Japanese Women

The Relation Between Sacral Angle and Vertical Angle of Sacral Curvature and Lumbar Disc Degeneration

Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness

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