Are There Correlations Between Facet Joint Parameters and Lumbar Disk Herniation Laterality in Young Adults?

Background: We aimed to determine whether there is an association, in young adults, between the occurrence of lumbar disk herniation（LDH）at a given segment and the segment’s facet joint parameters [facet orientation (FO) and tropism (FT)]. In addition, associations between facet joint parameters in the corresponding segment and LDH laterality were also investigated.Methods: We retrospectively analyzed data from 529 patients who were between 18 and 35 years old, who had experienced single-level LDH (L4–5 or L5–S1) between June 2017 and December 2019, and with less than 2 years of clinical history. We included an additional 122 patients with no history of LDH as an age-matched control group. LDH were classified by laterality (left-sided, right-sided, or central herniation). At each level (L4–L5 or L5–S1 segments), we investigated the relationship between facet joint parameters and herniation laterality. Results: FOA values at the L4–L5 level and the L5–S1 level were significantly lower and FT was higher for the LDH group compared with those for the control group. The level at which LDH occurred, FOL, FOR, and FT differed significantly among the three groups. There was a significant association between herniation laterality and FO at the L4–L5 level but not at the L5–S1 level.Conclusions: Abnormal facet joint parameters are significantly associated with LDH. Young adults with higher FT should be paid more attention, to prevent the occurrence of LDH. At the L4–L5 level, intervertebral disk herniation tended to occur ipsilateral to the side with a lower facet joint angle when FT was present.

Serum apolipoprotein B/apolipoprotein A1 ratio in relation to intervertebral disk herniation: a cross-sectional frequency-matched case–control study

Study design This was a cross-sectional frequency-matched case–control study. Background and aim The serum lipid profile of lipoprotein(a) [Lp(a)] level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/Apo A1) ratio were found to be more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the blood levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were found to be associated with symptomatic intervertebral disk herniation (IDH), no studies to date have evaluated the association of Apo AI, Apo B, Lp(a), and Apo B/Apo AI levels with symptomatic IDH. This study aimed to assess the link between blood lipid levels and symptomatic IDH. Method The study included 1839 Chinese patients. Of these, 918 patients were diagnosed with IDH and enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B, and Apo B/Apo AI were examined and analyzed. The control group comprised randomly selected patients who met the baseline levels of the aforementioned lipid molecules. Results Patients with IDH exhibited significantly higher TC, TG, LDL, Apo B, and Lp(a) levels than controls. The percentage of high TC, high TG, high LDL, high Apo B, and high Lp(a) were obviously higher in the IDH group than in the control group. However, hyperlipidemia had no relationship with the degenerated segment of the IDH (P = 0.201). The odds ratio (OR) for the incidence of IDH with elevated levels of LDL-C, TC, TG, Lp(a), Apo B, and Apo B/Apo AI was 1.583, 1.74, 1.62, 1.58, 1.49, and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a), and incidence of IDH was significant (R2LDL = 0.017; R2TC = 0.004; R2TG = 0.015; R2Apo B = 0.004; R2Lp(a) = 0.021) (P < 0.05). Conclusion This study suggested that elevated levels of serum TC, TG, LDL, Apo B, Lp(a), and Apo B/Apo AI were associated with a higher risk of IDH. This study provided useful information to identify a population that might be at risk of developing IDH based on elevated lipid levels.

Anästhesiedauer beeinflusst Prognose nach Diskopathie-Operation

Joe Fenn J, Ru H, Jeffery ND et al. Association between Anesthesia Duration and Outcome in Dogs with Surgically Treated Acute Severe Spinal Cord Injury Caused by Thoracolumbar Intervertebral Disk Herniation. J Vet Intern Med 2020. doi: 10.1111/jvim.15796. Die thorakolumbale intervertebrale Diskherniation (IVDH, „Diskopathie“) stellt beim Hund die häufigste Ursache einer akuten Rückenmarksschädigung dar. Am schwersten betroffene Patienten sind paraplegisch und weisen zum Zeitpunkt der Vorstellung keinen Tiefenschmerz auf. Nach dekompressiver Hemilaminektomie schwankt die Erfolgsrate zwischen 25 % und 76 %. Ein Einflussfaktor auf diese Variabilität ist die Perfusion des Rückenmarks. Durch hämodynamische Auswirkungen der Anästhesie (z. B. Bradykardie, Hypotension) kann deren Dauer die Prognose beeinflussen. Ziel dieser Studie war zu untersuchen, ob bei Hunden mit Tiefenschmerz-negativer IVDH ein Zusammenhang zwischen der Anästhesiedauer und dem postoperativen Verlauf besteht.