Plain radiographic findings of L5/S1 disc herniation and the significance of L5/S1 disc space narrowing

1982 ◽  
Vol 18 (4) ◽  
pp. 803
Author(s):  
S G Shin ◽  
I Y Cho ◽  
C J Lee ◽  
I S Whang
Keyword(s):  
Disc Herniation ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Radiographic Findings

Case Example: Adjacent Segment Disease: What Is It, and How Is It Rated?

2011 ◽  
Vol 16 (2) ◽  
pp. 8-9
Author(s):  
Marjorie Eskay-Auerbach
Keyword(s):  
Clinical Symptoms ◽  
Lumbar Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Disc Space Narrowing ◽  
Disc Disease ◽  
Disc Space ◽  
Radiographic Findings ◽  
Asymptomatic Patients

Abstract The incidence of cervical and lumbar fusion surgery has increased in the past twenty years, and during follow-up some of these patients develop changes at the adjacent segment. Recognizing that adjacent segment degeneration and disease may occur in the future does not alter the rating for a cervical or lumbar fusion at the time the patient's condition is determined to be at maximum medical improvement (MMI). The term adjacent segment degeneration refers to the presence of radiographic findings of degenerative disc disease, including disc space narrowing, instability, and so on at the motion segment above or below a cervical or lumbar fusion. Adjacent segment disease refers to the development of new clinical symptoms that correspond to these changes on imaging. The biomechanics of adjacent segment degeneration have been studied, and, although the exact mechanism is uncertain, genetics may play a role. Findings associated with adjacent segment degeneration include degeneration of the facet joints with hypertrophy and thickening of the ligamentum flavum, disc space collapse, and translation—but the clinical significance of these radiographic degenerative changes remains unclear, particularly in light of the known presence of abnormal findings in asymptomatic patients. Evaluators should not rate an individual in anticipation of the development of changes at the level above a fusion, although such a development is a recognized possibility.

scholarly journals Neglected alkaptonuric patient presented with low back pain and radiculopathy: A case report

2022 ◽  
Vol 13 ◽  
pp. 15
Author(s):  
Mohammad Moein Vakilzadeh ◽  
Sajjad Saghebdoust ◽  
Bita Abbasi ◽  
Reza Zare
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Urine Specimen ◽  
Low Back ◽  
Connective Tissues ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Disc Herniations

Background: Alkaptonuria (AKU) is a rare hereditary disorder in which excess homogentisic acid (HGA) deposits in connective tissues (ochronosis). Here, we report the unusual presentation of a lumbar disc herniation occurring in a patient with AKU warranting surgical intervention. Case Description: A 28-year-old male presented with 1 year of low back pain. The lumbar magnetic resonance imaging showed an extruded disc at the L4-L5 level accompanied extensive disc space narrowing and osteophyte formation. At surgery, the interspinous ligaments, facet joints, and disc herniation were black. In addition, the postoperative re-examination revealed a black discoloration of the nasal and ear cartilage. Finally, the diagnosis of AKU was confirmed when the urine specimen was positive for HGA. Conclusion: Rarely, younger patients with AKU who develop excess black deposits of HGA in connective tissues (i.e., ochronosis) may present with lumbar disc herniations and spondylosis.

scholarly journals Relationship between diffuse idiopathic skeletal hyperostosis and fragility vertebral fracture: a prospective study in older men

Rheumatology ◽  
2020 ◽  
Author(s):  
Anaïs Guiot ◽  
Charline Estublier ◽  
Marine Gaude ◽  
Pawel Szulc ◽  
Roland Chapurlat
Keyword(s):  
Vertebral Fracture ◽  
Fracture Risk ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Older Men ◽  
Fracture Prediction ◽  
Intervertebral Space ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Vertebral Fracture Risk ◽  
A Prospective Study

Abstract Objective To analyse the risk of incident vertebral and non-vertebral fracture in men with DISH. Methods In 782 men ages 50–85 years, DISH was diagnosed using Resnick’s criteria. In men followed prospectively for 7.5 years, a radiographic incident vertebral fracture was defined by a decrease of ≥20% or ≥4mm in any vertebral height vs baseline. Self-reported incident non-vertebral fractures were confirmed by medical records. Results Men with DISH had higher BMD at the lumbar spine (P < 0.05), but not at other skeletal sites. After adjustment for confounders including disc space narrowing (DSN) and endplate irregularity, the risk of vertebral fracture was higher in men with DISH vs men without DISH [10/164 (6.1%) vs 16/597 (2.7%), P < 0.05; odds ratio (OR) 2.89 (95% CI 1.15, 7.28), P < 0.05]. DISH and low spine BMD were each associated with a higher vertebral fracture risk. The vertebral fracture risk was higher in men who had both DISH and severe DSN. DISH and endplate irregularities (EIs) were each associated with higher vertebral fracture risk. DISH, DSN and EIs define the intervertebral space dysfunction, which was associated with higher vertebral fracture risk [OR 3.99 (95% CI 1.45, 10.98), P < 0.01]. Intervertebral space dysfunction improved the vertebral fracture prediction (ΔAUC = +0.111, P < 0.05), mainly in men with higher spine BMD (>0.9 g/cm2; ΔAUC = +0.189, P < 0.001). DISH was not associated with the risk of non-vertebral fracture. Conclusion DISH is associated with higher vertebral fracture risk, independently of other risk factors. Assessment of the intervertebral space dysfunction components may improve the vertebral fracture prediction in older men.

Image analysis techniques for characterizing disc space narrowing in cervical vertebrae interfaces

2004 ◽  
Vol 28 (1-2) ◽  
pp. 39-50 ◽  
Author(s):  
Pavan Chamarthy ◽  
R.Joe Stanley ◽  
Gregory Cizek ◽  
Rodney Long ◽  
Sameer Antani ◽  
...  
Keyword(s):  
Image Analysis ◽  
Cervical Vertebrae ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Analysis Techniques ◽  
Image Analysis Techniques

scholarly journals Imaging features of discospondylitis in cats

2019 ◽  
Vol 22 (7) ◽  
pp. 631-640 ◽  
Author(s):  
Sergio A Gomes ◽  
Sebastien Behr ◽  
Laurent S Garosi ◽  
Ines Carrera ◽  
Mike Targett ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Imaging Features ◽  
Nerve Roots ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Radiographic Findings ◽  
Mri Features ◽  
Vertebral Bodies ◽  
Vertebral Endplates ◽  
Short Tau Inversion Recovery

Objectives This study describes the imaging features of feline discospondylitis on MRI, comparing them with CT and radiographic findings where available. Methods The medical records of cats diagnosed with discospondylitis, presented to three referring institutions, were reviewed. MRI, CT and radiographic features were assessed by two of the authors independently. Results Fourteen sites of discospondylitis were retrospectively identified in 13 cats. The L7–S1 intervertebral disc space (IVDS) was affected in 7/14 (50%) cases. Characteristic MRI features included a hyperintense nucleus pulposus signal on T2-weighted (T2W) imaging (n = 10/14 [71%]) and short tau inversion recovery (STIR) imaging (n = 11/13 [85%]), with contrast enhancement in all (n = 11/11); involvement of adjacent vertebral endplates (n = 11/14 [79%]) and hyperintense neighbouring soft tissue on T2W (n = 11/14 [79%]) and STIR (n = 10/13 [77%]), with contrast enhancement in all (n = 11/11); and the presence of spondylosis deformans (n = 10/14 [71%]). Other features included narrowed or collapsed IVDS (n = 8/14 [57%]), contrast enhancement of vertebral bodies (n = 5/11 [46%]), epidural space involvement (n = 5/14 [36%]), compression of the spinal cord or nerve roots (n = 5/14 [36%]), paraspinal abscessation (n = 3/14 [21%]) and meningeal signal intensity abnormalities with contrast enhancement (n = 5/6 [83%]). These latter findings may indicate secondary focal meningitis. Radiographs were available covering five sites (in four cats) and CT covering three sites (in two cats). The most common radiological features were collapse or narrowing of the affected IVDS (80%) and endplate erosion (60%). No changes suggestive of discospondylitis were identifiable on radiography or CT in two sites (one cat), despite being identifiable on MRI. Repeated radiography in one case did not reveal complete radiological resolution following 9 months of treatment. Conclusions and relevance The results of this study indicate consistent MRI features of feline discospondylitis that should be considered in the diagnosis of this condition.

scholarly journals Inflammatory, Structural, and Pain Biochemical Biomarkers May Reflect Radiographic Disc Space Narrowing: The Johnston County Osteoarthritis Project

2019 ◽  
Vol 38 (5) ◽  
pp. 1027-1037 ◽  
Author(s):  
Adam P. Goode ◽  
Todd A. Schwartz ◽  
Virginia B. Kraus ◽  
Janet L. Huebner ◽  
Steven Z. George ◽  
...  
Keyword(s):  
Disc Space Narrowing ◽  
Disc Space ◽  
Biochemical Biomarkers

scholarly journals Novel genetic variants associated with lumbar disc degeneration in northern Europeans: a meta-analysis of 4600 subjects

2012 ◽  
Vol 72 (7) ◽  
pp. 1141-1148 ◽  
Author(s):  
Frances M K Williams ◽  
Aruna T Bansal ◽  
Joyce B van Meurs ◽  
Jordana T Bell ◽  
Ingrid Meulenbelt ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Disc Degeneration ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Low Back ◽  
Lumbar Disc Degeneration ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Genome Wide

ObjectiveLumbar disc degeneration (LDD) is an important cause of low back pain, which is a common and costly problem. LDD is characterised by disc space narrowing and osteophyte growth at the circumference of the disc. To date, the agnostic search of the genome by genome-wide association (GWA) to identify common variants associated with LDD has not been fruitful. This study is the first GWA meta-analysis of LDD.MethodsWe have developed a continuous trait based on disc space narrowing and osteophytes growth which is measurable on all forms of imaging (plain radiograph, CT scan and MRI) and performed a meta-analysis of five cohorts of Northern European extraction each having GWA data imputed to HapMap V.2.ResultsThis study of 4600 individuals identified four single nucleotide polymorphisms with p<5×10−8, the threshold set for genome-wide significance. We identified a variant in the PARK2 gene (p=2.8×10−8) associated with LDD. Differential methylation at one CpG island of the PARK2 promoter was observed in a small subset of subjects (β=8.74×10−4, p=0.006).ConclusionsLDD accounts for a considerable proportion of low back pain and the pathogenesis of LDD is poorly understood. This work provides evidence of association of the PARK2 gene and suggests that methylation of the PARK2 promoter may influence degeneration of the intervertebral disc. This gene has not previously been considered a candidate in LDD and further functional work is needed on this hitherto unsuspected pathway.

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