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Kinetic magnetic resonance imaging analysis of lumbar segmental motion at levels adjacent to disc herniation

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Abstract

Purpose

A retrospective radiographic study was carried out to analyze the effect of lumbar disc herniation on the kinetic motion of adjacent segments.

Methods

A total of 162 patients with low back pain or radicular pain in the lower limbs without a prior history of surgery were evaluated using kinetic magnetic resonance imaging. Translational motion, angular variation, and disc height were measured at each segment from L1–L2 to L5–S1. Other factors including the degree of disc degeneration, age, gender, and vertebral segment location were analyzed to determine any predisposing risk factors for segmental instability adjacent to disc herniations.

Results

Spinal levels above the disc herniation exhibited, on average, a 6.4 % increase in translational motion per mm of disc herniation (P = 0.496) and a 21.4 % increase in angular motion per mm herniation (P = 0.447). Levels below the herniation demonstrated a 5.2 % increase in translational motion per mm of disc herniation (P = 0.428) and a decrease of 10.7 % in angular motion per mm (P = 0.726). The degree of disc degeneration had no significant correlation with adjacent level motion. Similarly, disc herniation was not significantly correlated with disc height at adjacent levels, although there was a significant relationship between gender and adjacent segment disc height.

Conclusions

Although disc height, translational motion, and angular variation are significantly affected at the level of a disc herniation, no significant changes are apparent in adjacent segments. Our results indicate that herniated discs have no effect on range of motion at adjacent levels regardless of the degree of disc degeneration or the size of disc herniation, suggesting that the natural progression of disc degeneration and adjacent segment disease may be separate, unrelated processes within the lumbar spine.

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Conflict of interest

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Lifeng Lao & Guibin Zhong

  2. Department of Orthopaedic Surgery, University of California at Los Angeles (UCLA), Los Angeles, CA, USA

    Michael D. Daubs, Shinji Takahashi, Elizabeth L. Lord & Jeremiah R. Cohen

  3. Department of Orthopaedic Surgery, Keck School of Medicine of USC, 1520 San Pablo, HCT Suite 2000, Los Angeles, CA, 90033, USA

    Jeffrey C. Wang

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  1. Lifeng Lao
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  2. Michael D. Daubs
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  3. Shinji Takahashi
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  4. Elizabeth L. Lord
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  5. Jeremiah R. Cohen
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  6. Guibin Zhong
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  7. Jeffrey C. Wang
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Correspondence to Jeffrey C. Wang.

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Lao, L., Daubs, M.D., Takahashi, S. et al. Kinetic magnetic resonance imaging analysis of lumbar segmental motion at levels adjacent to disc herniation. Eur Spine J 25, 222–229 (2016). https://doi.org/10.1007/s00586-015-3977-z

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  • DOI: https://doi.org/10.1007/s00586-015-3977-z

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