Lumbar disc herniation: level increases with age
Section snippets
Patients and methods
Clinical data from 2838 patients suffering from lumbar back and sciatic pain were obtained from the neurologic database of Atrium Medical Center, Heerlen. Data from a time-span of 4 years (1995–1998) were collected retrospectively. Lumbar disc herniation was found in 1431 patients (50.4%). Mean age ± SEM was calculated. In turn, this was correlated to the level at which the disc herniation was localized. Either computed tomography (CT), magnetic resonance imaging (MRI), or both confirmed
Results
The distribution of lumbar disc herniation in our patient group is 40.9% at L5-S1, 38.0% at L4–5, 19.1% at L3–4, and 2.0% at L2–3.
The mean age for each level of herniation is given Table 1. The mean (± SEM) age at the different levels is 44.1 ± 0.5 years for at the L5-S1 level, 49.5 ± 0.6 for the L4–5 level, 59.5 ± 0.9 for the L3–4 level, and 59.6 ± 2.7 for the L2–3 level. The mean age of patients with lumbar disc herniation at levels L4–5, L3–4, and L2–3 is significantly higher than the mean
Discussion
Since the description of sciatica by Cotugno (1764) and the observations by Dandy, Mixter, and Barr in the late 1920s and early 1930s, a lot of knowledge has been accumulated of the epidemiology, symptomatology, and pathogenesis of herniated lumbar discs 3, 5. We know that lumbar disc disease is uncommon in the first two decades of life and peaks in the fourth decade. It occurs in men more often than in women. The two lower levels (L4–5 and L5-S1) are responsible for over 95% (50% and 46%,
References (13)
- et al.
Spinal mobility in the dog. A study in chondrodystrophoid and non-chondrodystrophoid animals
Res Vet Sci
(1977) What are the age-related changes in the spine?
Baillières Clin Rheumatol
(1998)- et al.
Surgery of lumbar disk herniahistorical perspective
Ann Ital Chir
(1998) - et al.
Disc degenerate before facets
Spine
(1990) - et al.
Seventy-five years after Dandy, Fay and Mixterlooking back on the history of neuroendoscopy
Zentralbl Neurochir
(1998) - et al.
Correlation of multiple objective diagnostic methods in lower lumbar disk disease
Clin Orthop
(1963)