Radiographic evaluation of the lumbosacral disc height.

Abstract

To establish criteria for the radiographic evaluation of narrowing of the L5-S1 disc height, which varies widely with transition of the L5 vertebra. Nondegenerated disc heights of L3-4 to L5-S1 and the thickness and length of the L5 transverse process were measured on plain radiographs of the lumbar spine in 166 outpatients, aged 18-35 years (mean 26.3 years), in whom at least the L3-4 and L5-S1 discs both showed normal signal intensity on magnetic resonance imaging. The level of the iliac crest was recorded semiquantitatively. The disc height was expressed as a percentage of the L3-4 disc height, namely "relative disc height". The ratio of disc height to the sagittal diameter of the overlying vertebral body was termed the "disc height index". The relative disc height and disc height index of L5-S1 showed strong negative correlations with two anatomic variables, which were the relative thickness of the transverse process and the level of the iliac crest (P<0.0001). The results of linear regression analysis suggest that narrowing of the L5-S1 disc height can be evaluated on plain radiographs alone in relation to these anatomic variables.