Investigation of possible relationship between three-dimensional radiological localization of herniated lumbar discs and their functional status

Abstract

Objective This study was designed to describe the localization and the extent of lumbar disc herniations (LDH) by three-dimensional radiological classification and to investigate their potential correlation with symptom and function evaluation.Methods The study retrospectively analyzed 261 patients (284 segments of herniated discs) who were diagnosed with LDH by computerized tomography (CT) or magnetic resonance imaging (MRI) from January 2006 to April 2010.There were 162 males and 99 females,with an average age of 42.1 years old (range,14-67 years) and the mean duration of history is 14.6 months (range,1-38 months).There were 35 cases of heavy manual workers,133 cases of moderate manual workers,and 93 cases of comfortable manual workers.The data were consisted of 188 MRI and 73 CT reports.The three-dimensional radiological classification was applied to describe the localization and the extent of LDH.Oswestry disability index (ODI) scores,Japanese Orthopaedic Association (JOA) scores and visual analogue scores (VAS) were applied to evaluate the vertebral symptom and function.The relationship between three-dimensional radiological classification and their functional status was probed.Results Herniations of lumbar discs located mainly sagittally at Level Ⅰ (151 segments,53.2％) and Level Ⅲ(122 segments,43.0％); horizontally at Area 2 (209 segments,73.6％)and Area 3 (61 segments,21.5％); and frontally at Area b (162 segments,57.0％),Area a (78 segments,27.5％) and Area c (41 segments,14.4％).The ODI scores at visit were 56.91％±13.62％,ranging from 20％ to 90％;JOA scores were ranging from 0 to 24 (mean,13.57±4.68); while VAS scores were ranging from 3 to 10 (mean,6.09±1.89).There was no significant difference on ODI scores,JOA scores and VAS scores between different herniation locations.Conclusion According to the three-dimensional radiological classification,most of the lumbar disc herniations located at Level Ⅰ sagittally,Area 2 horizontally,and Area b frontally.Clinical symptoms and lumbar function did not depend on the location of the lumbar disc herniations by the three-dimensional classification. Key words: Intervertebral disk displacement; Tomography, X-ray computed; Magnetic resonance imaging