Identification of lumbar disc disease hallmarks: a large cross-sectional study

Abstract

BackgroundLumbar disc disease has a disabling impact on global people with heavy burden on society, mainly consisting of lumbar disc degeneration (LDD) and lumbar disc herniation (LDH). The recently released lumbar disc nomenclature version 2.0 deepens our understandings on the diseases. Consequently, there is an urgent need to clarify the occurrence and distribution features of LDD and LDH in a large-scale sample in terms of the novel version.Question/purposesWe asked: (1) Is there a difference in the occurrence and distribution hallmarks of LDD and LDH in a population-based large-scale sample? (2) Does the novel nomenclature version bring novel vision on lumbar disc disease?MethodsFive thousand two hundred eighty-eight consecutive cases (26,440 lumbar discs) undergoing lumbar spine MRI were retrospectively included from Jan 2008 to Dec 2010 in a territory university hospital. Five hundred nine cases were excluded. There were 2727 males (51.57%) and 2561 females (48.43%) with a mean age of 43.73 years. Both T1 and T2 weighted lumbar MRI images from L1/2 to L5/S1 were profoundly analyzed in axial and sagittal planes. We classified lumbar discs in terms of version 2.0.ResultsThe occurrence of LDH and LDD was 14.18 and 44.23% in average, respectively. Notably, lumbar spine discs were more prone to LDD than LDH. L4/5 was the most frequent level in terms of LDH (26.08%) and LDD (56.09%), followed by L5/S1 (LDH: 24.09%; LDD: 55.33%), then L3/4, L2/3 and L1/2 in ranking order. The prevalence of LDH and LDD in upper lumbar discs from L1/2 to L3/4 was significant lower than the average prevalence rate (P < 0.05). The mean age was 24.70 (±14.81) years for normal lumbar discs; 49.76 (±14.95) years for LDD; 37.01 (±12.91) years for LDH; 51.31(±15.00) years for LDD and LDH (P < 0.05). Modic changes, HIZ, spondylosis deformans and decreased disc height were linked with older age; whereas Schmorl node and lumbar disc sequestration were not associated with age (P < 0.05).ConclusionsThe prevalence of LDD is 44.23%, higher than LDH as 14.18%. L4/5 and L5/S1 are the most frequent involved segments for the majority of lumbar disc diseases. Schmorl node occurs (1.6%) more frequently in upper lumbar spine, independent of age. Modic changes (0.87%) are closely related with older age.Clinical relevanceWhen diagnosing and treating lumbar disc disease, it might be important to consider the updated nomenclature of LDD and LDH. Our study provides additional novel vision on the features of LDD and LDH in a large-scale sample based on the nomenclature of novel version.

Association between hip joint impingement and lumbar disc disease in elite rowers

“… 19 There was a correlation seen between the alpha angle at 1 o’clock and the combined Pfirrmann score. Degenerative disc disease is the most common at L3/4, L4/5 and L5/S1 accounting for 70% of disc disease, 38 this was also the case in our cohort, and we found that a combined score for these discs again correlated with hip joint alpha angle. Furthermore internal rotation of the hip joint negatively correlated with the size of the alpha angle and also both combined Pfirrmann scores.…”

Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study

“…According to the nomenclature version 2.0 11 and the Pfirrmann grading scheme, 13 12 Two experienced spine surgeons (two of the authors) specializing in spinal diseases assessed the MRI of all cases, respectively. Over 1 month interval, these cases were reassessed by the same surgeons.…”

“…11 Based on a study by Zhang and colleagues, a large scale cross-sectional study, consisting of 5,288 consecutive cases (26 440 lumbar discs), was performed and published in 2016. 12 In the study, the authors reported the MRI imaging findings of lumbar discs of the Chinese population. In lieu of the aforementioned limitations in the literature addressing the MRI phenotypes of the lumbar spine in children and adolescents, we conducted a crosssectional epidemiological study to address such shortcomings.…”

Electroacupuncture for lumbar disc herniation

“…LDH has bad influence on people's daily life, work and lifestyle, even leads to long term depression, chronic neurofunction deficit and disability. [ 5 ] In recent years, the incidence of LDH has been rising and the onset age has inclined to be younger. [ 6 ] The recurrence and complication place a heavy enough burden on both individual and the society.…”