[Interspinous spacers and disc herniation. Geomorphometric and clinical study of 71 cases treated by L4-L5 microdiscectomy associated to spacer placement]

Spinal health in 40 patients in the initial stage of laboural life. Morfogeometric, biological and environmental study

Introduction

Assuming that spinal shape is a genetic expression, its analysis and acquired factors could assess their respective contribution to early spine deterioration.

Material and methods

A geometric morphometric analysis was retrospectively performed on sagittal lumbar MRI of young patients with back pain to identify lumbar spine shape changes. Using Geometric Morphometrics, findings were analyzed with anthropometric, radiological, and clinical variables.

Results

80 cases under 26 years of age were collected, 55 men (mean age 22.81) and 25 women (mean age 23.24). MRI abnormalities were reported in 57.5%: single altered disc (N=17), root compromises (N=8), and transition anomalies (35%).In the non-normal MRI subgroup, shape variation included: increased lordosis, enlarged vertebral body, canal stenosis, and lumbarization of S1. In non-Spanish origin patients, lumbar straightening and segmental deformities were prevalent. Morphometrics findings showed that lumbosacral transition anomalies are frequently underreported.

Conclusions

Genetic factors could be the main determinants of abnormality in MRIs under 26 years. The primary markers are transitional abnormalities, segmental deformities, and canal stenosis. In foreign populations, shape changes could suggest spine overload at an early age.