Does the sagittal spinal profile differ between the elderly Chinese populations with and without lumbar disc herniation?

Objective: To explore the characteristics of the sagittal spinopelvic profile in the elderly Chinese population with lumbar disc herniation (LDH) and to evaluate its influence on the severity, location and number of disc degeneration.

Methods: A retrospective analysis was conducted on 212 elderly Chinese patients with LDH and 213 asymptomatic volunteers with matched age and sex. Sagittal spinopelvic parameters were measured on the full-length X-ray and the sagittal profiles were determined according to the Roussouly classification. The severity, location and number of lumbar disc degeneration were evaluated from the L12 to L5S1 discs on the MRI images.

Results: There were no significant differences in BMI between the two groups. Patients with LDH were found to have significantly smaller TK, LL, and SS than those in the asymptomatic population (P < 0.05), while contradicting observations were obtained of PT and TPA (P < 0.05). In the LDH group, Roussouly type 1 and type 2 (50.4% and 28.7%, respectively) were predominant and the proportion of type 1 in the elderly LDH population was further increased compared to the younger LDH population. LDH population with Roussouly type 1 and 2 showed more caudal herniated locations and fewer herniated numbers than those with type 3 and 4.

Conclusion: The sagittal spinopelvic profile was significantly different between the elderly Chinese population with and without LDH. There were significant differences in the Roussouly distribution between the elderly and the younger groups and different Roussouly types have different effects on the lumbar disc degeneration patterns.