Curve pattern of lumbosacral list in patients with lumbar disc herniation

BackhroundsThere are many unanswered questions about the characteristics and mechanism oflumbosacral scoliotic list (LSL). In current study, the pattern of LSL, the level of maximalbending (take-off) and the relationship between location of disc herniation (DH) onmagnetic resonance imaging (MRI) and LSL direction on x-rays were investigated.Methods: 37 patients with extruded lumbar DH and LSL enrolled in current study. Thefollowing variables were measured on standing antero-posterior and lateral lumbarx-rays: LSL (from L1 to L5), the take-off level and the coronal shift (the distance betweenthe plump line from T12 spinous process to the central sacral vertical line). The directionof LSL was recorded as the bending side of the patient opposite to the convexity of thecurve. The location of DH was determined as right, left or central on MRI.ResultsLSL averaged °6.9±9.9. In right and left hernias, the list occurred significantly to theopposite side of the herniation direction (p=0.04). There was no significant relationshipbetween level of herniation and level of take-off (p=0.391), however, in %67.6 ofpatients with L-4L5 and L-5S1 hernias, take-off was found at a level above. The take-offwas found at L-3L4 or L-4L5 levels in all the patients.ConclusionsLSL occurs usually in opposite side of the herniation location. Furthermore, due tothe biomechanical properties, take-off is found in L-3L4 or L-4L5 levels in most of thepatients with LSL. It seems that LSL pattern is not affected by the level of herniation.