The Association of Lumbar Disc Herniation with Lumbar Volumetric Bone Mineral Density in a Cross-Sectional Chinese Study

Abstract

Little is known about the effect of lumbar intervertebral disc herniation (LDH) on lumbar bone mineral density (BMD), and few previous studies have used quantitative computed tomography (QCT) to assess whether the staging of LDH correlates with lumbar vertebral trabecular volumetric bone mineral density (Trab.vBMD). To explore the relationship between lumbar Trab.vBMD and LDH, seven hundred and fifty-four healthy participants aged 20–60 years were enrolled in the study from an ongoing study on the degeneration of the spine and knee between June 2014 and 2017. QCT was used to measure L2–4 Trab.vBMD and lumbar spine magnetic resonance images (MRI) were performed to assess the incidence of disc herniation. After 9 exclusions, a total of 322 men and 423 women remained. The men and women were divided into younger (age 20–39 years) and older (age 40–60 years) groups and further into those without LDH, with a single LDH segment, and with ≥2 segments. Covariance analysis was used to adjust for the effects of age, BMI, waistline, and hipline on the relationship between Trab.vBMD and LDH. Forty-one younger men (25.0%) and 59 older men (37.3%) had at least one LDH segment. Amongst the women, the numbers were 46 (22.5%) and 80 (36.4%), respectively. Although there were differences in the characteristics data between men and women, the difference in Trab.vBMD between those without LDH and those with single and ≥2 segments was not statistically significant (p > 0.05). These results remained not statistically significant after further adjusting for covariates (p > 0.05). No associations between lumbar disc herniation and vertebral trabecular volumetric bone mineral density were observed in either men or women.

Q‐Dixon and GRAPPATINI T2 Mapping Parameters: A Whole Spinal Assessment of the Relationship Between Osteoporosis and Intervertebral Disc Degeneration

“…11 Additionally, it has been conjectured that there is no significant association between osteoporosis and IVD degeneration. 12 Therefore, the association between osteoporosis and IVD degeneration remains controversial and unclear, and the mechanism of interaction between osteoporosis and IVD degeneration needs to be elucidated.…”

“…For example, a study of postmenopausal women in Finland revealed an association between higher lumbar spine bone mineral density (BMD) and more severe IVD degeneration, 10 and a study by Wang et al showed that severe IVD degeneration was more severe in postmenopausal women than in men and that a lower BMD was associated with less severe IVD degeneration 11 . Additionally, it has been conjectured that there is no significant association between osteoporosis and IVD degeneration 12 . Therefore, the association between osteoporosis and IVD degeneration remains controversial and unclear, and the mechanism of interaction between osteoporosis and IVD degeneration needs to be elucidated.…”

Editorial on Special Issue “Spine Imaging: Novel Image Acquisition Techniques and Analysis Tools”

“…Regarding potential associations between the degenerative spine and BMD, Geng et al investigated 745 participants (aged 20 to 60 years) by MRI to assess disc herniations and by dedicated quantitative CT (QCT) to extract BMD (L2–4) [ 25 ]. According to the results of their study, the differences in BMD between subjects without and those with single or ≥2 sites of lumbar disc herniation were not statistically significant, and no associations between BMD and lumbar disc herniation were observed in either men or women [ 25 ].…”

Editorial for “Q‐Dixon and GRAPPATINI T2 Mapping Parameters: A Whole Spinal Assessment of the Relationships Between Osteoporosis and Intervertebral Disc Degeneration”

“…1 Although studies have proposed evidence supporting a relationship between sex hormones, menopause, and intervertebral disc (IVD) degeneration, 2,3 the association between osteoporosis and IVD degeneration is controversial. 4 Pathophysiological processes such as the conversion of hematopoietic cells to adipocytes have been extensively shown to be fundamental to the pathway to osteoporosis. 5 Although the classical Pfirrmann grading system has been identified to be highly subjective, previous studies have explored this system to evaluate pathological changes.…”

“…This disease is characterized by bone mass reduction, bone tissue microstructural degeneration, and increased susceptibility to fracture 1 . Although studies have proposed evidence supporting a relationship between sex hormones, menopause, and intervertebral disc (IVD) degeneration, 2,3 the association between osteoporosis and IVD degeneration is controversial 4 …”