Relationship between bone structure parameters in lower lumbar spine and lumbar disc herniation

Lin Zhi-jun; Li Yu-mao; Xie Xiao-yong; Li Ping-sheng; Li Tian-ran; Liu Ai-hua; Liu Hang-tao

doi:10.3969/j.issn.2095-4344.2014.35.020

Abstract：BACKGROUND:Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative stil deserves further exploration. OBJECTIVE:To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc. METHODS:From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle. RESULTS AND CONCLUSION:Process deflection angle at L 4 and L 5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z=-10.609,-12.074, P<0.01). There was not significant statistical difference between the lower lumbar disc herniation group and the control group on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle at various ages (P>0.05). There only was significant difference on lumbosacral angle between male group and female group (P=0.007<0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P<0.01), and there was significant difference between 45-54 age group and 25-34 age group (P<0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration.