The Role of Radiological Parameters of Spinal Motion Segment in the Outcome of Surgical Treatment for Lumbar Intervertebral Disc Hernia

Abstract

To assess a spectrum of X-ray biomechanical parameters of the spine kinematic chain and to determine their influence on the outcome of surgical treatment for lumbar intervertebral disc hernia. Material and Methods. A retrospective analysis of data on 332 patients operated on for intervertebral disc hernias at the L4-L5 and L5-S1 levels was performed. Patients were distributed into two groups: I-patients with hernia recurrence, and II-without recurrence. Preoperative X-ray parameters were compared. Results. Hernia recurrence was observed within 10.40 ± 1.18 months after primary surgery. Intervertebral disc height index was 0.35±0.06 mm in Group I and 0.26 ± 0.03 mm in Group II. This determined a significant difference between groups (P = 0.001) and meaningful correlation (ρ = 0.44). Sagittal range of motion was 10.20° ± 1.84° in Group I and 7.60° ± 1.74° in Group II (P = 0.001, ρ = 0.35); central lordosis angle was 32.80° ± 5.73° in Group I and 47.10° ± 8.15° in Group II (P = 0.001, ρ =-0.46). Recurrence correlated with Pfirrmann grade III degeneration (ρ = 0.42) and articular cartilage degeneration grade according to Grogan (ρ = 0.32). The slope of a chord, Modic changes, hernia types, subchondral sclerosis according to Grogan classification, lumbalization, and retrolisthesis did not correlate with recurrence, though significantly differed in the studied groups. Conclusion. Analysis of data on radiological parameters can help to optimize the surgical approach and improve the outcome of treatment for lumbar intervertebral disc hernias.

Annuloplasty as a Method to Prevent the Recurrence of the Lumbar Intervertebral Disc Herniation: A Literature Review

“…Основными факторами риска рецидивов поясничных межпозвонковых грыж можно считать возраст, курение, пол, травму, массу тела, стадию дегенерации и высоту межпозвонкового диска, объем движения позвоночно-двигательного сегмента, тип грыжи и т.д. [5,14,16,22,25,33] [18] изучали частоту рецидивирования межпозвонковых грыж в зависимости от размера дефекта фиброзного кольца и агрессивности дискэктомии. Оказалось, что в группе пациентов, которым выполняли лимитированную микродискэктомию, рецидив грыжи диска и реоперации наблюдали в 18 и 10 % случаев, в группе агрессивной (субтотальной) микродискэктомии данные показатели соответствовали 9 и 7 % случаев.…”