The correlation between histopathology of herniated lumbar intervertebral disc and clinical findings

Abstract

Objective: Prolapsed lumbar disc is one of the most frequent diseases, which is usually presented by motor and sensory deficits. Consistency of herniated disc may play a significant role in surgical treatment and postoperative improvement. The objective of this study is to assess whether the histopathological degeneration in the sample of lumbar discs operated on is correlated to clinical variables and surgical outcomes. Materials and Methods: A randomized double-blind prospective study of lumbar disc prolapse cases over a period of 24 months was done. Forty cases were initially included in the study. All the included cases with a scheduled lumbar discectomy in the Department of Neurosurgery, King Fahd University Hospital, Al-Khobar, Saudi Arabia, during this period were examined histologically. Results: Finally, 21 patients were only considered in this study due to loss of follow-up of the other 19 patients; of these 21 patients, 18 were male and 3 were female. The youngest patient was 32 years old, and the oldest was 72 years old. There is no significant correlation between the major histopathological changes of the prolapsed discs and the clinical findings of low back pain (correlation coefficient = 0.058, P < 0.8), duration of sciatica (correlation coefficient = −0.337, P < 0.1), paresthesia (correlation coefficient = 0.111, P < 0.6), motor weakness (correlation coefficient = 0.274, P < 0.2), and reflex (correlation coefficient = 0.081, P < 0.7). Meanwhile, the correlation coefficient between numbness and histopathological degeneration score (HPDS) is not defined because all reported cases were presented with numbness. Conclusions: There is no significant correlation between the histopathological changes of the prolapsed discs and some clinical findings. Moreover, the different types of prolapsed discs' histopathological changes have no impact on the outcome of the surgery. We also concluded that the disc material undergoes certain degenerative processes with age.

Correlations of Disc Tissue Pathological Changes With Pfirrmann Grade in Patients With Disc Herniation Treated With Microdiscectomy

“…Their study revealed tears or formation of clefts, edge neovascularization and rim lesions, mucoid degeneration, and chondrocyte proliferation as the most frequent alterations in degenerated discs. Ammar et al analyzed disc specimens from 21 patients with disc herniation according to aging-associated pathological disc changes classified previously by Boos et al [ 1 ]. They reported that they found no significant pathological changes in herniated disc specimens, such as increased cartilage cell proliferation and clusters, within the nucleus pulposus.…”

“…The most common cause of radicular pain is lumbar disc herniation with a lifetime prevalence of about 10% [ 1 ]. One of the most likely causes of this problem is intervertebral disc degeneration and according to some studies, this degeneration is the key alteration that causes low back pain [ 1 , 2 ].…”

“…The most common cause of radicular pain is lumbar disc herniation with a lifetime prevalence of about 10% [ 1 ]. One of the most likely causes of this problem is intervertebral disc degeneration and according to some studies, this degeneration is the key alteration that causes low back pain [ 1 , 2 ]. Hence, one would expect that the intensity of pain in patients with disc herniation would directly correlate with pathological disc alterations.…”

Pathological Examination of Radiologically Fused Interbody Tissue Five Years After Anterior Cervical Discectomy and Fusion Using the Titanium Cage System: A Report of Two Cases

“…In addition, vertebral degenerative diseases are associated with degenerative cartilage endplates [9]. Cartilage cell proliferation and degenerated fibrocartilaginous stroma are often observed in herniated lumbar intervertebral discs [10]. The underlying cervical degeneration from the ACDF presents another potential contributor to the growth of fibrocartilage tissue in the titanium spacers.…”

Correlation of clinical manifestation of lumbar disc prolapse with magnetic resonance imaging findings among adult patients

“…LBP also occurs due to psycho-social factors and abnormal biomechanics. Deterioration in the structure of the spine changes the natural environment of the cells of the disc and results in cell-mediated degeneration that causes low back pain [1,2] . About 80% of patients of disc prolapse among the adult population present with LBP [3] .…”