Geometric Mapping of the Lumbar Vertebral Column in the United Arab Emirates

Abstract

Lower back pain, originating in the lumbar vertebral region, is often overlooked in the public healthcare system as it is deemed to be an undramatic problem. While treating it poses a challenge for orthopaedicians, lumbar spine disorders are also considered to be one of the most expensive ailments from a socio-economic perspective. Since eighty percent of the adult population in the United Arab Emirates (UAE) is reported to present with lumbar spine disorders, often attributed to ageing, fall from a height, and traffic-related injuries; this study developed a reproducible computational model of the lumbar vertebral column that was representative of the local and expatriate populations of the UAE. Serial 2D MRI scan slices of lumbar vertebral columns were extracted from an existing image database and were reconstructed into fifty 3D MRI models (n = 50). Morphometric evaluation and classification of morphological features of the lumbar vertebrae were then conducted. Although the first lumbar vertebral body appeared to be oval in shape (58%), the bodies of lumbar vertebrae (L) 2-5 were predominantly kidney-shaped. The presence of osteophytes was noted between L3-L4 (16%) and L4-L5 (16%), suggesting underlying degenerative changes. Mean values were also established for the anterior vertebral height (27.84±4.58mm), posterior vertebral height (25.42±2.64mm), superior vertebral width (43.93±10.84mm) and L1/L2 intervertebral disc height (15.34±8.27mm). As this study incorporated reference planes, a global coordinate system and geometric base shapes into the simulation process, the 3D MRI models may act as a reference against which normal and degenerative lumbar vertebral columns are assessed in clinical practice. It may also contribute to advances in diagnostic approaches, pre-operative planning, physical therapy and positive patient outcomes in the UAE healthcare system.