IJCRR - 7(2), January, 2015
Pages: 21-40
AGE AND GENDER RELATED CHANGES IN MIDSAGITTAL DIMENSIONS OF THE LUMBAR SPINE IN NORMAL EGYPTIANS: MRI STUDY
Author: Fathy Ahmed Fetouh
Category: Healthcare
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Abstract:
Background: Degeneration of lumbar spine is a common and age related finding in the normal population. Eighty percent of adult population suffer from at least one episode of low back pain during their life time.
Objective: The present work aimed to study the midsagittal dimensions of lumbar vertebrae, intervertebral discs, and vertebral canal in normal Egyptian population in different age groups in both males and females using MRI.
Materials and methods: A retrospective study of MRI midsagittal images of lumbar spine was carried out for normal Egyptian population whose ages ranged from 20 to 60 years old and divided into 4 age groups (decades). The parameters measured for the discs were; anterior, central, posterior disc heights, relative disc height index and anteroposterior disc diameter, while the parameters measured for the vertebrae were; central height, anteroposterior diameter, midsagittal canal diameter and canal/ body ratio. The data were statistically analyzed and tested for significance between age groups and between males and females.
Results: The measured parameters of the discs increased with age progress with significant differences at different levels between age groups. Also, they were found to be greater in males than females with significant differences. The relative disc height index showed a constant relationship between males and females. For the vertebrae, the parameters showed no significant differences related to age progress, while they were greater in males than females at all levels in all age groups. The midsagittal canal diameter and canal/body ratio indicated that the canal diameter decreased steadily from 3rd to 6th decade and was more capacious in females than in males.
Conclusion: The measurements obtained in the present study can be considered as a database which can be helpful to clinicians, therapists, and researchers as ready references of lumbar spine in normal adult Egyptian population. Any deviation from these values should be correlated with clinical findings.
Keywords: Aging, Sexual dimorphism, Lumbar intervertebral disc, Midsagittal canal diameter, MRI
Citation:
Fathy Ahmed Fetouh. AGE AND GENDER RELATED CHANGES IN MIDSAGITTAL DIMENSIONS OF THE LUMBAR SPINE IN NORMAL EGYPTIANS: MRI STUDY International Journal of Current Research and Review. 7(2), January, 21-40
References:
1. Takeda N, Kobayashi T, Atsuta Y, Matsuno T, Shirado O, Minami A. Changes in the sagittal spinal alignment of the elderly without vertebral fractures: a minimum 10-year longitudinal study. J Orthop Sci 2009; 14(6):748 -753.
2. Twomey L, Taylor J. Age changes in the lumbar spinal and intervertebral canals. Paraplegia 1988;26:238-249.
3. Shao Z, Rompe G, Schiltenwolf M. Radiographic changes in the lumbar intervertebral discs and lumbar vertebrae with age. Spine 2002; 27; 263-268.
4. Vernon-Roberts B, Moore RJ, Fraser RD. The natural history of age-related disc degeneration: the influence of age and pathology on cell populations in the L4-L5 disc. Spine (Phila Pa 1976) 2008;33:2767-2773.
5. Naylor A. The biophysical and biochemical aspects of intervertebral disc herniation and degeneration. Ann R Coll Surg 1962; 31: 91-114.
6. Ferguson SJ, Steffen T. Biomechanics of the aging spine. Eur Spine J 2003; 2: S97-S103.
7. Abbas J, Hamoud K, May H, Hay O, Medlej B, Masharawi Y, et al. Degenerative lumbar spinal stenosis and lumbar spine configuration. Eur Spine J 2010;19:1865-73.
8. Santiago FR, Milena GL, Herrera RO, Romero PA, Plazas PG. Morphometry of the lower lumbar vertebrae in patients with and without low back pain. Eur Spine J 2001; 10(3):228-233.
9. Gepstein R, Folman Y, Sagiv P, Ben David Y, Hallel T. Does the anteroposterior diameter of the bony spinal canal reflect its size? An anatomical study. Surg Radiol Anat 1991;13:289-291.
10. Sevinc O, Barut C, Is M, Eryoruk N, Safak A. Influence of age and sex on lumbar vertebral morphometry determined using sagittal magnetic resonance imaging. Ann Anat 2008; 190:277-83.
11. Aydinlioglu A, Diyarbakirli S, Keles P. Heights of the lumbar intervertebral discs related to age in Turkish individuals. Tohoku J Exp Med 1999; 188: 11-22.
12. Amonoo-Kuofi HS. Morphometric changes in the heights and anteroposterior diameters of the lumbar intervertebral discs with age. J Anat 1991; 175: 159-168.
13. Al-Hadidi MT, Badran DH, Al-Hadidi AM, Abu-Ghaida JH. Magnetic resonance imaging of normal lumbar intervertebral discs. Neurosciences 2001; 6 (4): 227-232.
14. Shao Z, Rompe G, Schiltenwolf M. Radiographic changes in the lumbar intervertebral discs and lumbar vertebrae with age. Spine 2004; 29:108-9.
15. Gocmen-Mas N, Karabekir H, Ertekin T, Edizer M, Canan Y Izzet duyar I. Evaluation of lumbar vertebral body and disc: a stereological morphometric study. Int J Morphol 2010;28 (3):841-847.
16. Amonoo-Kuofi HS. The sagittal diameter of the lumbar vertebral canal in normal adult Nigerians. J Anat 1985; 140 (1): 69-78.
17. Twomey LT, Taylor JR. Age changes in lumbar vertebrae and intervertebral discs. Clin Orthop Relat Res 1987; 224:97-104.
18. Lee HM, Kim NH, Kim HJ, Chung IH. Morphometric study of the lumbar spinal canal in the Korean population. Spine 1995 (Phila Pa 1976) 20:1679-1684.
19. Tacar O, Demirant A, Nas K, Altinda? O. Morphology of the lumbar spinal canal in normal adult Turks. Yonsei Med J 2003; 44(4):679-685
20. Jahangir M, Dar S, Jeelani G. Antero-posterior measurement of the lumbar spinal canal on mid sagittal MRI in Kashmiri adults. JK-Practitioner.2003; 10(4): 284-285.
21. Al-Anazi A, Munir N, Khaled M, Hosam A. Radiographic measurement of lumbar spinal canal size and canal/body ratio in normal adult Saudis. Neurosurgery Quarterly 2007; 17 (1):19-22.
22. Kim KH, Park JY, Kuh SU, Chin DK, Kim KS, Cho YE. Changes in spinal canal diameter and vertebral body height with age. Yonsei Med J 2013;54 (6):1498-1504.
23. Oda J, Tanaka H, Tsuzuki N. Intervertebral disc changes with aging of human cervical vertebra from neonate to the eighties. Spine 1988; 13: 1205-1211.
24. Frobin W, Brinckmann P, Biggemann M, Tillotson M, Burton K. Precision measurement of disc height, vertebral height and sagittal plane displacement from lateral radiographic views of the lumbar spine. Clin Biomech 1997; 12(1):51- 63.
25. Bernick S, Cailliet R. Vertebral end-plate changes with aging of human vertebrae. Spine 1982;7:97–102.
26. Anderson DG, Li X, Tannoury T, Beck G, Balian G. A fibronectin fragment stimulates intervertebral disc degeneration in vivo. Spine 2003;28:2338–45.
27. Buckwalter JA. Aging and degeneration of the human intervertebral disc. Spine (Phila Pa 1976) 1995;20 (11):1307- 14.
28. Pokharna HK, Phillips FM. Collagen cross-links in human lumbar intervertebral disc aging. Spine 1998;23:1645- 1648.
29. Eijkelkamp MF, Klein JP, Veldhuizen AG, Van Hom JR, Verkerke GJ. The geometry and shape of the human intervertebral disc. The International Journal of Artificial Organs. 2001; 24: 75-83.
30. Moeller TB, Reif E. Normal Findings in CT and MRI. First edition, Thieme, Stuttgart, Germany. 2000: 82 & 174.
31. Bogduk N, Tynan W, Wilson AS. The nerve supply to the human lumbar intervertebral discs. J Anat 1981; 132: 39-56
32. Shukri IG, Mahmood KA, Abdulrahman SA. a morphometric study of the lumbar spine in a symptomatic subjects in Sulaimani city by magnetic resonance imaging. JSMC, 2013; 3(1):21-31.
33. Masharawi Y, Salame K, Mirovsky Y, Peleg S, Dar G, Steinberg N, et al. Vertebral body shape variation in the thoracic and lumbar spine: characterization of its asymmetry and wedging. Clin Anat 2008;21:46-54.
34. Sone T, Tomomitsu T, Miyake M, Takeda N, Fukunaga M. Age-related changes in vertebral height ratios and vertebral fracture. Osteoporos Int 1997; 7:113-118.
35. Goh S, Tan C, Price RI, Edmondston J, Song S, Davis S, Singer KP. Influence of age and gender on thoracic vertebral body shape and disc degeneration: an MR investigation of 169 cases. J Anat 2000; 197: 647-657.
36. Frobin W, Brinckmann P, Biggemann M, Tillotson M, Burton K. Precision measurement of disc height, vertebral height and sagittal plane displacement from lateral radiographic views of the lumbar spine. Clin Biomech (Bristol, Avon) 1997;12(suppl 1):51- 64.
37. Gilsanz V, Boechat MI, Gilsanz R, Loro ML, Roe TF, Goodman WG. Gender differences in vertebral sizes in adults: biomechanical implications. Radiology 1994;190: 678-682.
38. Standring S, Ellis H, Healy JC, Johnson D, Williams A, Collins P et al. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. Thirty-ninth edition, Elsevier Churchill Livingstone, Edinburgh; 2005: 735-756 & 789-793.
39. Panjabi MM, White AA. 3rd Basic biomechanics of the spine. Neurosurgery 1980;7:76-93.
40. Panjabi MM, Goel V, Oxland T, Takata K, Duranceau J, Krag M, et al. Human lumbar vertebrae. Quantitative three-dimensional anatomy. Spine (Phila Pa 1976) 1992;17:299- 306.
41. Ericksen MF. Some aspects of aging in the lumbar spine. Am J Phys Anthropol 1976;45(3 pt. 2):575-580.
42. Janjua MZ, Muhammad F. Measurements of the normal adult lumbar spinal canal. J Pak Med Assoc 1989; 39(10):264-8
43. Wang TM, Shih C. Morphometric variations of the lumbar vertebrae between Chinese and Indian adults. Acta Anatomica 1992; 144: 23-29.
44. Rema D, Rajagopalan N. Dimensions of the lumbar vertebral canal. Indian J Orthop 2003; 37(3): 44-46.
45. AkI M, Zidan A. Morphometry of the lumbar spine and lumbosacral region in Egyptians. Egypt Orthop J 1983; 18:34–43.
46. El-Rakhawy M, El-Shahat A, Labib I, Abdulaziz E. Lumbar vertebral canal stenosis: concept of morphometric and radiometric study of the human lumbar vertebral canal. Anatomy 2010; 4: 51-62.
47. Aly T, Amin O. Geometrical dimensions and morphological study of the lumbar spinal canal in the normal Egyptian population. Orthopedics 2013;36(2):e229-34.
48. Eisenstein S. The morphometry and pathological anatomy of the lumbar spine in South African Negroes and Caucasoids with specific reference to spinal stenosis. J Bone Joint Surg. 1977; 59 B:173-180.
49. Malas MA, Salbacak A, Aler A, Yardimci C. Mid sagittal diameters of the lumbar vertebral canal determined by magnetic resonance imaging. SDÜ Tip Fakültesi Dergisi. 1997; 4(3): 7-11.
50. Adam, RAA. Measurement of lumbar canal diameter in Sudanese population using computerize tomography scanning. Sudan University of Science and Technology, Medical Radiologic Science 2011, M.Sc. Thesis.
51. Gupta M, Bharihoke V, Bhargava S.K. Agrawal N. Size of the Vertebral Canal—A correlative study of measurements in radiographs and dried bones. J Anat Soc India 1998;47: 1-6.
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