Relationship of Lumbar Spinal Anatomical Structures With Lumbar Disc Hernia and Spinal Stenosis

Abstract

Objective: We aimed to radiologically evaluate the clinical and demographic features accompanying ligamentum flavum hypertrophy and possible accompanying differences in anatomical structures. Materials and Methods: We evaluated vertebral alignment, integrity of neural structures, diameter of the central canal, posterior longitudinal ligament, ligamentum flavum integrity, and position of the facet joints in patients with lumbar disk herniation and lumbar spinal canal stenosis using magnetic resonance imaging (MRI). Furthermore, we examined the age, body mass index (BMI), and employment status of the patients and the status of the vertebral and paravertebral anatomical structures using MRI. Age, BMI, employment status, ligamentum flavum thickness at the L4–L5 level, interspinous ligament thickness, facet joint diameter, posterior longitudinal ligament integrity, psoas muscle diameter, erector spina muscle diameter, and mean multifidus muscle diameter were also analyzed. Results: Significant differences were found in age, BMI, employment status, ligamentum flavum thickness, interspinous ligament thickness, mean facet diameter, mean multifidus muscle diameter, mean erector spina muscle diameter, and mean psoas muscle diameter. In addition, separate statistical analyses were conducted between sex, age, employment status, BMI, and lumbar anatomical parameters. Significant correlations were found between lumbar disk herniation and spinal stenosis pathologies based on radiological measurements of lumbar structures, such as the ligamentum flavum, interspinous ligament, and facet diameter, and demographic parameters, such as age, sex, employment status, and BMI. Conclusion: We examined changes in the anatomical structures accompanying the vertebral column and existing discal or stenotic pathologies. In addition to the demographic characteristics of the patients, changes in the accompanying lumbar spinal anatomical structures, such as degeneration, hypertrophy, and atrophy, may be important. These factors and changes will help plan the treatment process and guide the results.