Correlation between lumbar intervertebral disc height and lumbar spine sagittal alignment among asymptomatic Asian young adults

Feng Zhang, Kai Zhang, Hai-Jun Tian, Ai-Min Wu, Xiao-Fei Cheng, Tang-Jun Zhou, Jie Zhao, Feng Zhang, Kai Zhang, Hai-Jun Tian, Ai-Min Wu, Xiao-Fei Cheng, Tang-Jun Zhou, Jie Zhao

Abstract

Background: To investigate the distribution and characteristics of the lumbar intervertebral disc height (IDH) in asymptomatic Asian population and to determine whether the lumbar IDH is related to the lumbar spine sagittal alignment.

Methods: A cohort of 169 cases of asymptomatic volunteers was enrolled from January 2014 to July 2016. All participants underwent magnetic resonance imaging of the lumbar spine and panoramic radiography of the spine. Panoramic radiographs of the spine were taken to evaluate pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) using Surgimap® software. Roussouly classification was utilized to categorize all subjects according to the four subtypes of sagittal alignment. The IDH was measured on the MRI mid-saggital section of the vertebral body. The relationships between lumbar IDH and spine-pelvic parameters were also assessed using the Spearman correlation analysis.

Results: The reference value ranges of IDH in asymptomatic Asian volunteers between L1/2, L2/3, L3/4, L4/5, and L5/S1 were (6.25, 10.99), (6.97, 12.08), (7.42, 13.3), (7.76, 14.57),and (7.11, 13.12) mm, respectively. Based on the above reference value, the high lumbar intervertebral space is defined as more than 14 mm. According to the Roussouly Classification, there are 33 cases in type I, 48 in type II, 66 in type III, and 22 in type IV. According to the definition of the high IDH, there are two cases in type I, three in type II, nine in type III, and eight in type IV. The results indicated that people in the Roussouly III and IV subtypes had greater values for IDH compared to those of Roussouly I and II subtypes, and the spinopelvic parameters were partly correlated with IDH in different subtypes. In addition, levels L4-L5 showed the highest IDH for all four groups followed by the L3-L4 and L5-S1 levels, and the value of L3-L4 is equivalent to that of L5-S1. All type groups showed moderate and positive correlations between the PI and IDH except the level of L1-L2 in type IV.

Conclusions: The IDH may influence the lumbar spine sagittal alignment in asymptomatic Asian adults. Moreover, pre-operative evaluation of IDH is useful for selection of optimal cage size and reconstruction of spinal alignment.

Keywords: Intervertebral disc height; Lumbar spine sagittal alignment; Pelvic incidence; Roussouly classification.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the IRB (institutional review board) of the Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, and informed consent was obtained from every participant.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Panoramic radiographic of four types of sagittal alignment. a Roussouly type I. b Roussouly type II. c Roussouly type III. d Roussouly type IV
Fig. 2
Fig. 2
IDH and VH measured on the mid-saggital section of the vertebral body using the PACS workstation
Fig. 3
Fig. 3
Pelvic parameters measured with Surgimap: pelvic tilt (PT) and pelvic incident (PI)
Fig. 4
Fig. 4
The ratio of IDH/VH in the same segment intercompared in the four subtypes. There was significant statistical difference between types II vs. IV in the level of L1–L2 and L2–L3

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