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Magnetic resonance morphometry of the adult normal lumbar intervertebral space

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Abstract

Purpose

This study aims to: (a) quantify and evaluate normal relationships between neighboring spinal units using MR imaging indices, (b) propose an easy-to-apply-and-reproduce method of estimating the correct amount of distraction when surgically restoring a collapsed intervertebral disc, based on individualized measurements.

Methods

This is a retrospective cross-sectional MR imaging study of 119 adult subjects, aged 18–54, asymptomatic for low back pain. Each of the examinees should demonstrate two or more consecutive intervertebral discs classified as Pfirrmann grade I or II to be included. We measured and studied the relationships of disc height index, Dabbs index, Farfan index, disc convexity index and mean and posterior disc height per spinal level using multiple regression analysis. All measurements were tested for intra- and interobserver agreement by two raters.

Results

DHI, Dabbs, Farfan, and mean disc height had a statistically significant correlation with the spinal level and age. Our results were highly reproducible, with excellent inter- and intraobserver agreement and reliability between two raters (ICC = 0.992 and 0.994, respectively). Furthermore, we expressed each intervertebral space as a percentage of its adjacent space, introducing the coefficient α factor for every intervertebral space.

Conclusions

Our results suggest that a normal values’ database to refer during preoperative planning of correction of a degenerated intervertebral disc is feasible. Our study offers new anatomical and radiological insight in terms of spinal measurements and their potential correlation with current surgical techniques. A new approach for calculating disc space as an expression of its adjacent disc has been introduced with various potential applications.

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Authors and Affiliations

  1. Department of Anatomy, School of Medicine, University of Thessaly, Panepistimiou 3 (Biopolis), 41110, Larissa, Greece

    Apostolos H. Fyllos, Dimitrios L. Arvanitis & Aristeidis H. Zibis

  2. Department of Orthopedics, University Hospital of Larisa, 41110, Larissa, Greece

    Apostolos H. Fyllos, Sokratis E. Varitimidis & Michael Hantes

  3. Department of Radiology, School of Medicine, University of Crete, 71110, Heraklion, Greece

    Apostolos H. Karantanas

Authors
  1. Apostolos H. Fyllos
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  2. Dimitrios L. Arvanitis
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  3. Apostolos H. Karantanas
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  4. Sokratis E. Varitimidis
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  5. Michael Hantes
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  6. Aristeidis H. Zibis
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Contributions

AHF: Data analysis, manuscript writing. DLA: Project development, manuscript writing. AHK: Manuscript editing. SEV: Manuscript writing and editing. MH: Data collection and manuscript editing. AHZ: Project development, data collection, manuscript editing.

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Correspondence to Aristeidis H. Zibis.

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Fyllos, A.H., Arvanitis, D.L., Karantanas, A.H. et al. Magnetic resonance morphometry of the adult normal lumbar intervertebral space. Surg Radiol Anat 40, 1055–1061 (2018). https://doi.org/10.1007/s00276-018-2048-7

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  • DOI: https://doi.org/10.1007/s00276-018-2048-7

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