Abstract
PurposeThe sagittal alignment of the lumbar spine and pelvis can be classified into several subtypes. It has been suggested that the risk of developing certain pathologies, such as a lumbar disc herniation (LDH) is affected by spinal sagittal profiles. The main aim of this study was to investigate the sagittal profile in young patients surgically treated for a lumbar disc herniation and if a discectomy would alter the sagittal parameters.MethodsSixteen active young patients (mean age 18.3 ± 3.2 SD) with a lumbar disc herniation having a discectomy were included. A classification according to Roussouly of the sagittal parameters was made by two senior spinal surgeons, both pre-operatively and post-operatively on radiographs. The distribution of sagittal parameters and spinopelvic profiles were analysed and compared to a previous established healthy normal population.ResultsThis series of active young patients with LDH exhibited a low lumbar lordosis dominance, with Roussouly sagittal profiles type 1 and type 2 accounting for more than 75% of the examined patients. An analysis of the erect radiographs revealed no significant changes in the post-operative sagittal profile.ConclusionsThis study showed that sagittal spinal alignment according to Roussouly in a young population with LDH is skewed compared with a normal population cohort. Furthermore, the lack of post-operative correction is suggestive of a non-ephemeral response to a LDH. Roussouly type 2 spinal sagittal profile may be a risk factor in young individuals suffering a disc herniation.
Highlights
It has been hypothesised that certain spinal sagittal profiles might increase the risk of developing a lumbar disc herniation (LDH) [1]
Classification of the sagittal alignment and measurements of thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI) and corresponding to Roussouly et al in the four classical subtypes were independently performed by two senior spinal surgeons using blinded radiographs [13]
Interobserver correlation of radiographic measurements An analysis of the radiographic assessment revealed a high level of agreement in inter-observer measurements, with low variability
Summary
It has been hypothesised that certain spinal sagittal profiles might increase the risk of developing a lumbar disc herniation (LDH) [1]. The distribution of different sub-types in an unaffected population have been established in epidemiological studies by Mac-Thiong et al [5]. It has been suggested in previous work that a lumbar disc herniation could affect the degree of lumbar lordosis [6]. Disc herniation surgery in an active young patient population is a procedure with very low incidence. 20 LDH procedures per 100,000 inhabitants /year are performed in Sweden, Western Europe, whereas the incidence for young patients below the age
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