Abstract
Little is known about the effect of lumbar intervertebral disc herniation (LDH) on lumbar bone mineral density (BMD), and few previous studies have used quantitative computed tomography (QCT) to assess whether the staging of LDH correlates with lumbar vertebral trabecular volumetric bone mineral density (Trab.vBMD). To explore the relationship between lumbar Trab.vBMD and LDH, seven hundred and fifty-four healthy participants aged 20–60 years were enrolled in the study from an ongoing study on the degeneration of the spine and knee between June 2014 and 2017. QCT was used to measure L2–4 Trab.vBMD and lumbar spine magnetic resonance images (MRI) were performed to assess the incidence of disc herniation. After 9 exclusions, a total of 322 men and 423 women remained. The men and women were divided into younger (age 20–39 years) and older (age 40–60 years) groups and further into those without LDH, with a single LDH segment, and with ≥2 segments. Covariance analysis was used to adjust for the effects of age, BMI, waistline, and hipline on the relationship between Trab.vBMD and LDH. Forty-one younger men (25.0%) and 59 older men (37.3%) had at least one LDH segment. Amongst the women, the numbers were 46 (22.5%) and 80 (36.4%), respectively. Although there were differences in the characteristics data between men and women, the difference in Trab.vBMD between those without LDH and those with single and ≥2 segments was not statistically significant (p > 0.05). These results remained not statistically significant after further adjusting for covariates (p > 0.05). No associations between lumbar disc herniation and vertebral trabecular volumetric bone mineral density were observed in either men or women.
Highlights
Lumbar intervertebral disc herniation (LDH) refers to a displacement of the intervertebral disc tissue beyond the normal confines of the disk space, and the associated comorbidities are one of the major threats to work and functional ability [1]
Height (172.2 ± 5.9 vs. 160.5± 5.6 cm, p < 0.001), weight (77 vs. 59.5 kg, p < 0.001), BMI (25.9 vs. 23.2 kg/m2, p < 0.001), waistline (90 vs. 79 cm, p < 0.001), and hipline (101 vs. 95 cm, p < 0.001) for men were higher than for women, but women had higher lumbar vertebral volumetric BMD (vBMD) compared to men (163.8 ± 35.4 vs. 148.0 ± 31.1, p < 0.001)
Several earlier studies have appraised the relationship between intervertebral disc disease and lumbar and/or multipoint Bone mineral density (BMD) [21,22,23,24]
Summary
Lumbar intervertebral disc herniation (LDH) refers to a displacement of the intervertebral disc tissue beyond the normal confines of the disk space, and the associated comorbidities are one of the major threats to work and functional ability [1]. There is a high prevalence of such spinal abnormalities on imaging in asymptomatic patients, and approximately 85% of patients with sciatica are found to have a herniated intervertebral disk [3,6]. The relationship between LDH and bone health is unclear, the relationship between the lumbar intervertebral disc and the vertebral body is both physiologically and biomechanically close. The investigation of the associations between LDH and BMD would help us understand the impact of LDH on the incidence of osteoporotic vertebral fractures
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