Intervertebral disc heights and concavity index of the lumbar spine in young healthy adults

Demır, Mehmet; Atay, Emre; Seringec, Nurten; Yoldaş, Atila; Çiçek, Mustafa; Ertogrul, Rodi; Guneri, Bulent

doi:10.2399/ana.18.020

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…We constructed a straight-line model of the spine composed of weighted mean values of vertebral body heights (Berry et al, 1987;Busscher et al, 2010;Kunkel et al, 2011;Nissan and Gilad, 1984;Panjabi et al, 1992Panjabi et al, , 1991Scoles et al, 1988;Singh et al, 2011;Tan et al, 2004) and intervertebral disc heights of T10-L1 (Busscher et al, 2010;Demir et al, 2018;Fang et al, 1994;Fletcher et al, 2015;Frost et al, 2019;Koeller et al, 1984;Kunkel et al, 2011;Nissan and Gilad, 1984).…”

Section: Geometrical Model Of the Spine And The Lumbosacral Spinal Cordmentioning

confidence: 99%

Spinal motor mapping by epidural stimulation of lumbosacral posterior roots in humans

et al. 2021

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Epidural electrical stimulation of the spinal cord is an emergent strategy for the neurological recovery of lower-extremity motor function. Motoneuron pools are thought to be recruited by stimulation of posterior roots. Here, we linked electromyographic data of epidurally evoked lower-extremity responses of 34 individuals with upper motoneuron disorders to a population model of the spinal cord constructed using anatomical parameters of thousands of individuals. We identified a relationship between segmental stimulation sites and activated spinal cord segments, which made spinal motor mapping from epidural space possible despite the complex anatomical interface imposed by the posterior roots. Our statistical approach provided evidence for low-threshold sites of posterior roots and effects of monopolar and bipolar stimulation previously predicted by computer modeling and allowed us to test the impact of different upper motoneuron disorders on the evoked responses. Finally, we revealed a statistical association between intraoperative and postoperative mapping of the spinal cord.

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Section: Geometrical Model Of the Spine And The Lumbosacral Spinal Cordmentioning

confidence: 99%

Spinal motor mapping by epidural stimulation of lumbosacral posterior roots in humans

et al. 2021

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“…Whereas several authors have reported an association of disc height with age (either disc height increases with age or decreases with age, depending on the study), the strength of the association is very important to consider. [49][50][51][52][53][54] It is also possible that reporting disc height in units of percent endplate width minimize the differences between sexes compared to studies showing a difference in disc height between males and females when disc height is measured in millimeters. 53,54 Despite that publications and spine fusion coverage policies infer interchangeability of spondylolisthesis with instability 55 , this has been proven in several studies NOT to be true.…”

Section: Discussionmentioning

confidence: 99%

“…[49][50][51][52][53][54] It is also possible that reporting disc height in units of percent endplate width minimize the differences between sexes compared to studies showing a difference in disc height between males and females when disc height is measured in millimeters. 53,54 Despite that publications and spine fusion coverage policies infer interchangeability of spondylolisthesis with instability 55 , this has been proven in several studies NOT to be true. [56][57][58][59] There is no way to address this issue with the NHANES-II data, in large part due to the lack of validated diagnostic metrics for instability.…”

Section: Discussionmentioning

confidence: 99%

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Factors in measuring lumbar spondylolisthesis with reference data from NHANES-II

Hipp¹,

Grieco²,

Newman³

et al. 2022

Preprint

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Background Although spondylolisthesis, disc height loss, and abnormal disc angles are commonly assessed for in clinical practice and research studies, the factors that influence measurements are incompletely understood, and reference data representing a very large and diverse population are not available. Over 7000 lumbar spine x-rays were collected as part of the 2nd National Health and Nutrition Examination Survey (NHANES-II). This nationwide probability sample may facilitate development of robust reference data to objectively classify spondylolisthesis, disc heights, or disc angles as normal vs abnormal. Analysis of lumbar spine x-rays may also help to document whether disc heights and disc angles must be considered when assessing for spondylolisthesis. Methods Anatomic landmarks were obtained using neural networks and coded logic for L1 to S1 in the NHANES-II lumbar spine radiographs. Nine disc and sagittal plane offset (SPO) measurements were calculated from the landmarks. These data were trimmed to exclude abnormal discs and SPO. The factors that affect SPO were explored along with associations between the metrics and with age, sex, race, nation of origin and BMI. The prevalence of abnormalities was tabulated. Metrics were also calculated for previously analyzed lumbar flexion-extension x-rays to better understand the dependence of SPO on disc angles and disc heights. The errors that occur due to variability in radiographic projection were also assessed. Results SPO and disc metrics were obtained for 35,490 levels from 7,358 NHANES-II subjects who were 25 to 74 years old. Descriptive statistics for nine SPO and disc metrics were tabulated before and after trimming the data. Age, BMI, and sex were statistically significant but explained little of the variance in the metrics. SPO was significantly dependent on disc angle and height, though less so in the NHANES radiographs than in lumbar flexion-extension studies. Errors in the metrics due to out-of-plane imaging are generally small but can be large with extensive out-of-plane x-rays. Discussion The NHANES-II collection of lumbar x-rays allows for establishing reference data for SPO and disc metrics. These reference data allow for easily interpreted standardized reporting in units of std dev from average normal. SPO was significantly dependent on disc angle and disc height although the effect is small when there is limited flexion or extension. If SPO is being assessed from flexion or extension, a simple correction can be made. Caution is needed when interpreting measurements when the x-ray beam passes obliquely through the endplates or posterior wall (out-of-plane imaging). Conclusions The NHANES-II data may facilitate standardized assessments of SPO, disc heights and disc angles. Adjustments should be applied to SPO measurements if made from x-rays with the patient in flexed or extended positions.

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“…In addition to these, our study showed statistically that the anterior and posterior heights of the disc are generally preserved even in the patient group in early period after clinical signs. The progression of disc degeneration is one of the underlying pathologies of the degenerative lumbar diseases commonly seen in the elderly population (Akeda et al;Lee et al;Demir et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Is there Effect of Intervertebral Disc Herniation on the Lumbar Spine in Early Period? A Morphometric and Stereological Study

2020

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The degeneration of the Lumbar Intervertebral Disc (LIVD) and the other elements of the spine are an inevitable result of aging. However, it is observed that the same degree of degenerative change does not occur in each individual. In the present study, the purpose was to compare the morphometric changes on the lumbar spine with or without intervertebral disc herniation in early period. Group 1 (the Patient Group) consisted of the patients who were diagnosed with lumbar intervertebral disc hernia and who were not operated at least one month clinical duration. Group 2 (the Control Group) consisted of individuals who were selected randomly, had only back pain, underwent magnetic resonance imaging (MRI), and were determined to have intact intervertebral disc. The sagittal and axial MRI sections of lumbar spine was used for measurements and statistical evaluation. There were no statistically significant differences between the intervertebral disc volumes, vertebral body volumes and intervertebral disc anterior and posterior heights of Group 1 and 2 (p>0.05). In terms of anterior-posterior length, the length of the L5 vertebral body was determined to be more in the Patient Group (p<0.05). A correlation was determined in terms of the increase in L2, L4 and L5 volumes with increasing age; however, there were no statistically significant correlations between age increase and a decrease in the intervertebral disc volumes. There were no correlations between the increase in age and the decrease in intervertebral disc heights (p>0.05). There were no apparent relations between the change on the lumbar vertebra corpus and intervertebral disc in early period. It was concluded that the intact intervertebral disc could protect the lower lumbar vertebra corpus from degenerative changes. Although the herniation of the intervertebral disc is newly formed, it is understood that the physiological process or morphometric changes started earlier.

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Intervertebral disc heights and concavity index of the lumbar spine in young healthy adults

Cited by 6 publications

References 20 publications

Spinal motor mapping by epidural stimulation of lumbosacral posterior roots in humans

Spinal motor mapping by epidural stimulation of lumbosacral posterior roots in humans

Factors in measuring lumbar spondylolisthesis with reference data from NHANES-II

Is there Effect of Intervertebral Disc Herniation on the Lumbar Spine in Early Period? A Morphometric and Stereological Study

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