Lumbosacral morphology in lumbar disc herniation: a "chicken and egg" issue.

Abstract

The aim of this study was to analyze the relationship, if any, between lumbar disc herniation and lumbosacral morphology. Intervertebral disc angles (IDA), lumbar lordosis angle (LLA), lumbosacral lordosis angle (LSLA), lumbosacral angle (LSA), and sacral tilt (ST) were measured on lumbar magnetic resonance imaging of 224 patients with LDH (n=151) and without LDH (n=73) and were then compared. Regarding LLA, LSLA, LSA and ST, there were no significant differences between the 2 groups. The smallest IDA of each level (except L2-L3) was detected at the same level with disc herniation. When the relationship between the grade of disc herniation and IDA was evaluated in patients with LDH, angles of L3-L4 and L4-L5 levels were significantly smaller in patients with extruded disc herniation (p=0.009 and p=0.013, respectively). Despite changes in IDA by grade and level of disc herniation, no relation was found between lumbosacral alignment and LDH.