Analysis of MRI on the degeneration degree of herniated disc and adjacent disc in lumbar disc herniation

English Keywords:Lumber disc herniation  Adjacent disc  MRI

English Abstract:

  【Abstract】 Objectives: To analyze the MRI profile of protruding and its adjacent discs in lumbar disc herniation before surgery as well as the degree of degeneration, and to summarize their imaging features. Methods: 100 patients(56 males and 44 females, the rang of age was 23-79 and mean age was 51.68±5.60 years old) treated in spine surgery department of General Hospital of Ningxia Medical University from June 2014 to December 2015 were reviewed retrospectively. All patients were grouped into each age group for 10 years. There were 50 cases with L4/5 disc herniation of 100 adjacent discs, 50 cases with L5/S1 herniation of 50 adjacent discs. Pfirrmann Grading Standard was used for disc evaluation, and Pappou Grading Standard was used for evaluation of endplates from the preoperative MRI. Pearson correlation analysis was used to compare the correlation between adjacent disc and degenerative disc by using t-test. Results: In each range of age group, the Pfirrmann grade in segments herniated disc of L4/5, L5/S1 was over grade Ⅲ, and the Pappou grade was over grade Ⅱ, age appeared statistically significant(P<0.05) among all groups, cartilage endplate degeneration among all age groups was not statistically significant(P>0.05). Upper adjacent disc Pfirrmann grade of herniated disc occurred at L4/5 and L5/S1, all ages were statistically significant(P<0.05), lower adjacent disc was not statistically significant(P>0.05), adjacent endplate cartilage degeneration result for each age group was not statistically significant(P>0.05). Correlation existed in the Pfirrmann grade of adjacent disc L3/4 and herniated disc L4/5(r=0.696, P=0.000), while no correlation was noted between adjacent disc L5/S1 and herniated disc L4/5(r=0.214, P=0.136), adjacent disc L3/4, L5/S1 and herniated disc L4/5 endplate morphology Pappou grade was correlated(r=0.467, P=0.001; r=0.380, P=0.007). Adjacent disc L4/5 and herniated disc L5/S1 Pfirrmann grade was correlated(r=0.549, P=0.000); there was correlation in the adjacent disc L4/5 and herniated disc L5/S1 endplate cartilage morphology Pappou grade(r=0.684, P=0.001). Adjacent disc L3/4 Pfirrmann grade and cartilage endplate morphology Pappou grade scores were 3.26±0.87 and 1.54±0.50 respectively, which were higher than the adjacent disc L5/S1 of 2.96±0.59 and 1.23±0.49(P<0.05). Conclusions: There are correlations among adjacent disc, endplate, age and disc degeneration in patients, the upper adjacent disc degeneration changes significantly than the lower.