Direction of the formation of anterior lumbar vertebral osteophytes

Yuichi Kasai,Eiji Kawakita,Koji Akeda,Toshihiko Sakakibara,Atsumasa Uchida

doi:10.1186/1471-2474-10-4

Abstract

BackgroundX-ray images of lumbar degenerative diseases often show not only claw osteophytes, but also pairs of osteophytes that form in a direction away from the adjacent disc. We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration.MethodsThe direction of the formation of 14,250 pairs of anterior lumbar vertebral osteophytes across the adjacent intervertebral discs in 2,850 patients who were all over 60 years old was investigated. Anterior lumbar vertebral osteophytes were distributed into six groups based on the direction of extension of each pair of osteophytes across the intervertebral disc space.ResultsIn L1–L2 and L2–L3, the number of patients classified into groups B (the pair of osteophytes extended in the direction of the adjacent disc) and C (almost complete bone bridge formation by a pair of osteophytes across the intervertebral disc space) was larger than that classified into group D (the pair of osteophytes extended in a direction away from the adjacent disc). In L3–L4, L4–L5 and L5-S1, the number of patients in group D was greater than that of patients belonging to groups B and C.ConclusionOur study showed that pairs of osteophytes frequently formed in the direction of the adjacent disc in the upper lumbar vertebrae (L1–L2 and L2–L3) and in the direction away from the adjacent disc in middle or lower lumbar vertebrae (L3–L4, L4–L5, and L5-S1).

Highlights

X-ray images of lumbar degenerative diseases often show claw osteophytes, and pairs of osteophytes that form in a direction away from the adjacent disc
We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration
Plain X-ray films of the lumbar spine were obtained in a neutral lateral position and 14,250 pairs of cranial and caudal osteophytes were found across the intervertebral disc space at L1–L2, L2–L3, L3–L4, L4–L5, and L5-S1

Summary

Introduction

X-ray images of lumbar degenerative diseases often show claw osteophytes, and pairs of osteophytes that form in a direction away from the adjacent disc. The latter type is called traction osteophytes or traction spurs [5,6], and have been described as indicators of intervertebral instability on a plain radiographic image by Macnub et al [5]. We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration

Methods

Results

Discussion

Conclusion