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Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation

Background: The aim of this study was to determine whether the presence of disproportionate vertebral bodies is a risk factor for disc herniation (DH). Methods: Sixty-seven consecutive patients (m: 31 f: 36) who underwent lumbar discectomy for symptomatic DH at one level between L3 and S1 were retro...

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Autores principales: Läubli, Ralph, Brugger, Robin, Pirvu, Tatiana, Hoppe, Sven, Sieroń, Dominik, Szyluk, Karol, Albers, Christoph E., Christe, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307056/
https://www.ncbi.nlm.nih.gov/pubmed/34300340
http://dx.doi.org/10.3390/jcm10143174
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author Läubli, Ralph
Brugger, Robin
Pirvu, Tatiana
Hoppe, Sven
Sieroń, Dominik
Szyluk, Karol
Albers, Christoph E.
Christe, Andreas
author_facet Läubli, Ralph
Brugger, Robin
Pirvu, Tatiana
Hoppe, Sven
Sieroń, Dominik
Szyluk, Karol
Albers, Christoph E.
Christe, Andreas
author_sort Läubli, Ralph
collection PubMed
description Background: The aim of this study was to determine whether the presence of disproportionate vertebral bodies is a risk factor for disc herniation (DH). Methods: Sixty-seven consecutive patients (m: 31 f: 36) who underwent lumbar discectomy for symptomatic DH at one level between L3 and S1 were retrospectively included. The last three motion segments (3 × 67 = 201) were assessed on sagittal MRI scans. A disproportionate motion segment was defined as the difference of more than 10% of the antero-posterior diameter of two adjacent endplates. Results: DH was present in 6/67 (9%), 26/67 (38.8%), and 35/67 (52.2%) patients at L3/4, L4/5, and L5/S1, respectively. A total of 14 of 67 patients demonstrated a disproportionate motion segment at the discectomy level (20.9%). A total of 23 of the 201 (11.4%) investigated motion segments met our criteria for a disproportionate motion segment. In our study population, when one of the 201 segments was disproportionate, the positive predictive value (PPV) for DH increased toward the lower segments: the PPV at the L5/S1 level was 83.0%. The odds ratio of disproportion for DH was the highest at the L5/S1 level, with 6.0 ± 0.82 (p = 0.017). Conclusions: The presence of a disproportionate motion segment in the lower spine may lead to a significant higher risk for DH in patients undergoing discectomy.
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spelling pubmed-83070562021-07-25 Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation Läubli, Ralph Brugger, Robin Pirvu, Tatiana Hoppe, Sven Sieroń, Dominik Szyluk, Karol Albers, Christoph E. Christe, Andreas J Clin Med Article Background: The aim of this study was to determine whether the presence of disproportionate vertebral bodies is a risk factor for disc herniation (DH). Methods: Sixty-seven consecutive patients (m: 31 f: 36) who underwent lumbar discectomy for symptomatic DH at one level between L3 and S1 were retrospectively included. The last three motion segments (3 × 67 = 201) were assessed on sagittal MRI scans. A disproportionate motion segment was defined as the difference of more than 10% of the antero-posterior diameter of two adjacent endplates. Results: DH was present in 6/67 (9%), 26/67 (38.8%), and 35/67 (52.2%) patients at L3/4, L4/5, and L5/S1, respectively. A total of 14 of 67 patients demonstrated a disproportionate motion segment at the discectomy level (20.9%). A total of 23 of the 201 (11.4%) investigated motion segments met our criteria for a disproportionate motion segment. In our study population, when one of the 201 segments was disproportionate, the positive predictive value (PPV) for DH increased toward the lower segments: the PPV at the L5/S1 level was 83.0%. The odds ratio of disproportion for DH was the highest at the L5/S1 level, with 6.0 ± 0.82 (p = 0.017). Conclusions: The presence of a disproportionate motion segment in the lower spine may lead to a significant higher risk for DH in patients undergoing discectomy. MDPI 2021-07-19 /pmc/articles/PMC8307056/ /pubmed/34300340 http://dx.doi.org/10.3390/jcm10143174 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Läubli, Ralph
Brugger, Robin
Pirvu, Tatiana
Hoppe, Sven
Sieroń, Dominik
Szyluk, Karol
Albers, Christoph E.
Christe, Andreas
Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation
title Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation
title_full Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation
title_fullStr Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation
title_full_unstemmed Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation
title_short Disproportionate Vertebral Bodies and Their Impact on Lumbar Disc Herniation
title_sort disproportionate vertebral bodies and their impact on lumbar disc herniation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307056/
https://www.ncbi.nlm.nih.gov/pubmed/34300340
http://dx.doi.org/10.3390/jcm10143174
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