Morphometric Study of Lumbar Intervertebral Spaces (discs) by Using MRI.
Introduction: The radiological space between two vertebrae is known as intervertebral space (height) which corresponds to the thickness of the intervertebral disc. Lumbar intervertebral disc is the most important structure which maintains the spinal function. An early diagnosis of pathological changes in disc has clinical significance. Hence the study aimed to determine normal height of the intervertebral disc space and effect of aging. Methods: It was a cross-sectional analytical study performed on 106 images of MRI scans of lumbar region. Dimensions of lumbar intervertebral spaces (discs) such as the anterior, middle, posterior intervertebral space height were measured in millimeter. Results: The mean anterior intervertebral space height was gradually increased from L1-L2 level (6.91 mm) to L5-S1 level (13.55 mm). The middle intervertebral space height increased from L1-L2 level (7.89 mm) to L4-L5 level (11.96 mm) whereas at L5-S1 level, there was a decrease (11.10 mm). Similarly, the posterior intervertebral space height showed an increment from L1-L2 level (5.52 mm) to L4-L5 level (8.09 mm) except at L5-S1 level, where it was decreased (6.94 mm). All mean values were found to be higher in males than in females except posterior intervertebral space height. The height of disc was increased up to third or fourth decade followed by a decrease. Conclusion: Knowing the normal lumbar intervertebral space height could be helpful for clinicians to diagnose and plan for proper treatment. It may also help to generate baseline data and to produce proper devices for Nepalese population.
Standring S. Gray’s Anatomy the anatomical basis of clinical practice. 40th ed. Churchill- Livingstone: Elsevier; c2008. Chapter 5, The Back; p. 712-23. Available from: https://www.elsevier.com/books/grays-anatomy/standring/978-0-443-06684-9
Hong CH, Park JS, Jung KJ, Kim WJ. Measurement of the normal lumbar intervertebral disc space using magnetic resonance imaging. Asian Spine J. 2010;4(1):1-6. PMID: 20622948. DOI: https://doi.org/10.4184/asj.2010.4.1.1
Chaudhary S, Sarvesh, Batra APS, Gupta R, Swami S. A radiographic study of interpedicular distance of the lumbar vertebrae measured in plain antero-posterior radiographs. International Journal of Advanced Research. 2015;3(8):33- 6. Available from: http://www.journalijar.com/uploads/684_IJAR-4961.pdf
Allaire BT, Kaluza MCD, Bruno AG, Samelson EJ, Kiel DP, Anderson DE, et al. Evaluation of a New Approach to Compute Intervertebral Disc Height Measurements from Lateral Radiographic Views of the Spine. Euro Spine J. 2017;26(1):167-72. PMID: 27757680. DOI: https://doi.org/10.1007/s00586-016-4817-5
Onishi FJ, de Paiva Neto MA, Cavalheiro S, Centeno RS. Morphometric analysis of 900 lumbar intervertebral discs: Anterior and posterior height analysis and their ratio. Interdisciplinary Neurosurgery. 2019;18(0):100523. DOI: https://doi.org/10.1016/j.inat.2019.100523
Malkoc I, Aydinlioglu SA, Alper F, Kaciroglu F, Yuksel Y, Yuksel R, et al. Age related changes in height and shape of the lumbar intervertebral discus. European Journal of Basic Medical Science. 2012;2(3):68-73. Available from: https://www.researchgate.net/publication/330834477
Othman YA, Verma R, Qureshi SA. Artificial disc replacement in spine surgery. Ann Transl Med. 2019;7(Suppl 5):S170. PMID: 31624736. DOI: https://doi.org/10.21037/atm.2019.08.26
Fetouh FA. Age and gender related changes in midsagittal dimensions of the lumbar spine in normal Egyptians: MRI study. International Journal of Current Research and Review. 2015;7(2):21-40. Available from: https://www.ijcrr.com/past-articles.php?issueid=89
Alam MM, Waqas M, Shallwani H, Javed G. Lumbar morphometry: A study of lumbar vertebrae from a Pakistani population using computed tomography scans. Asian Spine J. 2014;8(4):421-6. PMID: 25187858. DOI: https://dx.doi.org/10.4184%2Fasj.2014.8.4.421
Mirab SMH, Barbarestani M, Tabatabei SM, Sahsavari S, Zangi MBM. Measuring dimensions of lumbar intervertebral discs in normal subjects. Anatomical Sciences Journal. 2017;14(1):3-8. Available from: http://anatomyjournal.ir/article-1-197-en.pdf
Gocmen-Mas N, Karabekir H, Ertekin T, Edizer M, Canan Y, Duyar I. Evaluation of lumbar vertebral body and disc: A stereological morphometric study. International Journal of Morphology. 2010;28(3):841-7. Available from: https://scielo.conicyt.cl/pdf/ijmorphol/v28n3/art28.pdf
Shukri IG, Mahmood KA, Abdulrahman SA. A morphometric study of the lumbar spine in a symptomatic subjects in Sulaimani city by magnetic resonance imaging. Journal of Sulaimani Medical College. 2013;3(1):21-31. DOI: https://doi.org/10.17656/jsmc.10028
Demir M, Atay E, Seringeç N, Yoldafl A, Çiçek M, Ertoğrul R, et al. Intervertebral disc heights and concavity index of the lumbar spine in young healthy adults. Anatomy. 2018;12(1):33-7. Available from: https://pdfs.semanticscholar.org/9ddb/a02e2c2d6cae428cc44ebc9e7ab901b1bbe6.pdf
Belavy DL, Quittner MJ, Ridgers N, Ling Y, Connell D, Rantalainen T. Running exercise strengthens the intervertebral disc. Scientific Reports. 2017;7(0):45975. Available from: https://www.nature.com/articles/srep45975.pdf
Mallikarjun MD, Chetan M, Patil S. Evaluation of degenerative lumbosacral diseases and common location of disc herniations causing radiculopa¬thy. International Journal of Anatomy, Radiology and Surgery. 2017;6(3):RO22-RO27. Available from: https://pdfs.semanticscholar.org/4792/5b5e163c16340ffd8271bc9d7e67520cb353.pdf
Ran B, Li Q, Yu B, Chen X, Guo K. Morphometry of lumbar spinous process via three dimensional CT reconstructions in a Chinese population. Int J Clin Exp. 2015;8(1):1129-36. PMID: 25785103.
Bakhsh A. Long-term outcome of lumbar disc surgery: an experience from Pakistan. J Neurosurg Spine. 2010;12(6):666-70. PMID: 20515353. DOI: https://doi.org/10.3171/2009.10.SPINE09142
David G, Ciurea AV, Iencean SM, Mohan A. Angiogenesis in the degeneration of the lumbar intervertebral disc. J Med Life. 2010;3(2):154- 61. PMID: 20968201.
Rao PJ, Phan K, Giang G, Maharaj MM, Phan S, Mobbs RJ. Subsidence following anterior lumbar interbody fusion (ALIF): A prospective study. J Spine Surg. 2017;3(2):168-75. PMID: 28744497. DOI: https://doi.org/10.21037/jss.2017.05.03
Bocahut N, Audureau E, Poignard A, Delambre J, Queinnec S, Lachaniette CHF, et al. Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion. Orthop Traumatol Surg Res. 2018;104(3):405- 10. PMID: 29292121. DOI: https://doi.org/10.1016/j.otsr.2017.11.018
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