Inequality in leg length is important for the understanding of the pathophysiology of lumbar disc herniation

Abstract

Objective:Inequality in leg length may lead to to abnormal transmission of load across the endplates and degeneration lumbar spine and the disc space. There has been no study focusing on lumbar disc herniation (LDH) and leg length discrepancy. This subject was investigated in this study.Materials and Methods:Consecutive adult patients with leg length discrepancy and low back pain (LBP) admitted to our department were respectivelly studied.Results:A total number of 39 subjects (31 women and eight men) with leg length discrepancy and LBP and 43 (25 females and 18 males) patients with LBP as a control group were tested. Occurrence of disc herniation is statistically different between patients with hip dysplasia and control groups (P < 0.05).Conclusion:The results of this study showed a statistically significant association between leg length discrepancy and occurrence of LDH. The changes of spine anatomy with leg length discrepancy in hip dysplastic patients are of importance in understanding the nature of LDH.

First report of perforation of ligamentum flavum by sequestrated lumbar intervertebral disc

“…[ 5 28 ] Asymmetric changes occur in intervertebral disc under asymmetric loading. [ 3 28 ] Left-sided epidural disc herniations in reported human studies may be explained by this way. Asymmetric features of epidural disc migration, and should be investigated, because treatment of spine pathologies should consider anatomic rule.…”

“…Low back pain has long been connected to postural and structural asymmetries. [ 3 5 28 ] While externally there is a difference in bilateral dimensions of various body parts and musculature, internally, it is due to asymmetrical positioning of viscera as well as variations in bilateral skeletal dimensions. [ 3 5 28 ] More stress and strain on the dominant side may cause differences between the sides, often referred to as directional asymmetry.…”

“…[ 3 5 28 ] While externally there is a difference in bilateral dimensions of various body parts and musculature, internally, it is due to asymmetrical positioning of viscera as well as variations in bilateral skeletal dimensions. [ 3 5 28 ] More stress and strain on the dominant side may cause differences between the sides, often referred to as directional asymmetry. Wolff 's law says bone formation occurs along lines of stress the bones and muscles respond by growing more vigorously and increasing in density on exposure to repeated high levels of mechanical loading.…”

“…Degenerative disc disease is one of the most common diseases of the spine. [ 1 2 3 ] Sciatica or lumbosacral radiculopathy is usually caused by disc herniation. [ 4 ] For decades, lumbar discectomy has been one of the most common surgical practices performed by neurosurgeons.…”

Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

“…Today, neurosurgical practices are confronted with overwhelming technological advancements [ 12 13 ], including catalytic advances in diagnostic imaging for spinal surgery [ 14 ]. Our understanding of spinal biomechanics and bone physiology, as well as the development of spinal fixation instrumentation has allowed exponential growth in this field [ 15 ].…”