Radiological analysis of upper lumbar disc herniation and spinopelvic sagittal alignment

Bae, Jang–Ho; Lee, Sang-Ho; Shin, Sang-Ha; Seo, Joong Seok; Kim, Kyeong Hwan; Jang, Jee-Soo

doi:10.1007/s00586-016-4382-y

Cited by 34 publications

(28 citation statements)

References 25 publications

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“…Li Song et al retrospectively studied upper lumbar disc herniation patients and found that 48.3% of them were classified as type 1, which is a much higher percentage than that of normal people [13] . Similar results have been found by J bae et al [14] . A study by Lee et al indicated a higher rate of Roussouly type 2 in patients with degenerative lumbar flat back than in patients without degenerative lumbar flat back [2] .…”

Section: The Roussouly Classification Is Based On Features Of Spine Msupporting

confidence: 92%

The characteristics of lumbar paraspinal muscle degeneration based on the Roussouly classification: a retrospective study

Yang

Zou

et al. 2020

Preprint

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Background: To analyse the characteristics of lumbar paraspinal muscle degeneration in individuals with different Roussouly types.Methods: Eighty patients (20 patients for each Roussouly type) with degenerative lumbar disease were retrospectively enrolled from January 2017 to February 2018. The cross-sectional area (CSA) and percentage of fat infiltration (FI) of the paraspinal muscles at the L1-S1 levels were measured using T2-weighted axial MRI and ImageJ software. The measured data were analysed with independent samples t-tests.Results: Degeneration of the paraspinal muscles of the upper lumbar region was significantly severer in Type 1 than in Type 3, the degrees of paraspinal muscle degeneration of Type 2 appeared to be more evenly distributed in all segments than Type 3, and Type 4 showed severer degeneration in L5-S1 than Type 3.Conclusion: The degree of paraspinal muscle degeneration in each segment was different across the four Roussouly types, but the degrees of degeneration were consistent with the characteristics of degenerative disease within each type.

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Section: The Roussouly Classification Is Based On Features Of Spine Msupporting

confidence: 92%

The characteristics of lumbar paraspinal muscle degeneration based on the Roussouly classification: a retrospective study

Yang

Zou

et al. 2020

Preprint

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“…Thus, both of these structures may be simultaneously compressed and disordered by a protrusive upper lumbar disc [13,14]. As the nerve roots in the upper lumbar spine do not innervate any specific muscles, upper LDH results in nonspecific clinical symptoms and neurological findings, which can lead to missed diagnosis of upper LDH [15,16].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Transforaminal Discectomy versus Conventional Open Lumbar Discectomy for Upper Lumbar Disc Herniation: A Comparative Cohort Study

Zhang

Chen

et al. 2020

BioMed Research International

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Background. Percutaneous endoscopic transforaminal discectomy (PETD) is regarded as a viable alternative option for upper lumbar disc herniation (LDH). However, few studies have evaluated PETD for upper LDH, and no study has compared the advantages of endoscopic procedures versus conventional surgery. The present study was aimed at comparing the surgical outcome and safety of PETD versus conventional open lumbar discectomy in the treatment of upper LDH. Methods. Data from 42 patients treated for upper LDH from July 2015 to July 2018 were retrospectively analyzed, including 21 patients treated with PETD (PETD group) and 21 patients treated with conventional posterior lumbar discectomy (open group). The two groups were compared regarding demographic information, physical examination, radiological evaluations, and perioperative indicators. The clinical outcomes were assessed in accordance with the Oswestry Disability Index (ODI), visual analog scale (VAS), and modified MacNab criteria. Results. The postoperative ODI and VAS scores were significantly improved in both groups compared with the preoperative baseline values (P<0.001), and the satisfactory rate was 90.5% in both groups in accordance with the modified MacNab criteria. There were no significant differences between the two groups in the clinical outcomes and complication rate (P>0.05); however, compared with the open group, the PETD group had significantly less blood loss, less postoperative drainage, shorter operation time, and shorter postoperative hospitalization (P<0.001). Conclusions. PETD has a similar outcome to the conventional surgical method for the treatment of upper LDH but provides the typical advantages of minimally invasive procedures such as reduced iatrogenic injury, minimal activity restrictions, and accelerated ambulation recovery postoperatively.

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“…Although the pathophysiology is not adequately comprehended, scoliosis and trunk shift have been seen as compensatory behaviour of the body to ease the stimulation of nerves. Spinopelvic imbalance was found in patients with LDH who have symptoms [5–9]. The development of these symptoms could result in certain alterations in the sagittal and coronal shape of the spine.…”

Section: Introductionmentioning

confidence: 99%

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

Chen

et al. 2019

J Orthop Surg Res

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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.

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Radiological analysis of upper lumbar disc herniation and spinopelvic sagittal alignment

Abstract: This study demonstrated the importance of PI and lumbar curvature in the pathogenesis of ULD. The higher prevalence of short LL and long TK with low PI in the ULD group implies that an increased mechanical stress at this level may be one of the risk factors of ULD.

Cited by 34 publications

References 25 publications

The characteristics of lumbar paraspinal muscle degeneration based on the Roussouly classification: a retrospective study

The characteristics of lumbar paraspinal muscle degeneration based on the Roussouly classification: a retrospective study

Percutaneous Endoscopic Transforaminal Discectomy versus Conventional Open Lumbar Discectomy for Upper Lumbar Disc Herniation: A Comparative Cohort Study

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

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