Effect Of Gender And Age Differences On Upper Lumbar Disc Herniation

Objective: Upper lumbar disc herniation is one of the most common causes for lumbocrural pain, which refers to the comprehensive clinical symptoms of adjacent tissue caused by oppression and stimulation of degenerated and fiber broken lumbar disc which herniates rearward or into the vertebral plate. The ratio of male to female is about 3.7:1in upper lumbar disc herniation patients. Lumbar degeneration and clinical symptoms of upper lumbar disc herniation aggravates with the increase of age. The study investigates the relationship between sex, age and clinical characteristics of upper lumbar disc herniation to provide reference for clinical treatment by case investigation and analysis.Methods:1 A total of 96 cases with ULDH were retrospectively analyzed from our inpatients of the Department of Orthopaedics in Hebei medical university affiliated third hospital from 2013 to 2015, including 60 men and 36 women ranging from 33 to 63 years old. The average age is 47.68±9.51 years old.2 All patients were given magnetic resonance imaging(MRI) using SIEMENS Verio SQ3.0T superconducting MR scanning instrument, whose parameter was set T2 WI vector potential, axial scan, body-array coil. The imaging parameters in T2 WI vector potential were as follows: TE of 101, TR of 3000, scanning layer thickness of 4 mm, spacing of 1.1 mm, 384 x 288, matrix FOV of 300 x 300. The imaging parameters in T2 WI axial potential were as follows TE of 112, TR of 3500, scanning layer thickness of 4 mm, spacing of 0.2 mm, 320 x 240, matrix FOV of 220 x 220.3 Patients were divided into male group(n=60) and female group(n=36) according to gender and elder group(≥48, n=50) and younger group(<48, n=46) according to age separately. Lumbar intervertebral disc protrusion grade, MRI signal intensity, Oswestry disability index(ODI) score and the Japanese orthopaedic Association(JOA) score were compared between the two groups separately.4 Data was processed with SPSS 19.0 software.Results:1 The comparison of grade according to Pfirrmann Lumbar intervertebral disc protrusion MRI grade standard between male group and female group was statistical different(P<0.05)which indicated that male group had more severe disease than female group in 96 patients of lumbar intervertebral disc protrusion. Intervertebral disc nucleus pulposus signal strength and intervertebral nucleus pulposus signal strength/cerebrospinal fluid signal intensity ratio of female group were significantly higher than that of male group, and the differences were statistically different(P<0.05). The female group had lower ODI scores than male group in lumbar disc prolapse(P< 0.05). The female group had higher JOA scores than male group in lumbar disc prolapse(P<0.05).2 The comparison of grade according to Pfirrmann Lumbar intervertebral disc protrusion MRI grade standard between elder group and younger group was statistical different(P<0.05)which indicated that elder group had more severe disease than younger group in 96 patients of lumbar intervertebral disc protrusion. Intervertebral disc nucleus pulposus signal intensity and intervertebral disc nucleus pulposus signal intensity/cerebrospinal fluid signal intensity ratio of younger group were higher than that of elder group, and the resuls were statistically significant(P<0.05). The ODI score of younger group was obviously lower than elder group, and the result was statistically different(P<0.05). The JOA score of younger group was obviously higher than elder group, and the result was statistically different(P<0.05).Conclusions:1 Grade of male group and female group according to Pfirrmann Lumbar intervertebral disc protrusion MRI grade standard is different, and it shows that male group have more severe disease than female group.2 The female patients have higer intervertebral disc nucleus pulposus signal strength and intervertebral nucleus pulposus signal strength/ cerebrospinal fluid signal intensity ratio than male patients suggesting that male has worse degenerated lumbar disc than female who are at the same age and have the same degenerated intervertebral disc.3 The female patients have lower ODI scores and higher JOA scores than male patients indicating that female has lighter disease and male has more severe disease of upper lumbar intervertebral disc protrusion.4 Grade of younger group and elder group according to Pfirrmann Lumbar intervertebral disc protrusion MRI grade standard is different showing that elder group have more severe disease than younger group.5 The younger group has higer intervertebral disc nucleus pulposus signal strength and intervertebral nucleus pulposus signal strength/cerebrospinal fluid signal intensity ratio than elder patients suggesting that younger group has lighter disease and elder group has more severe disease of upper lumbar intervertebral disc protrusion.6 The younger patients have lower ODI scores and higher JOA scores than elder patients indicating that younger group has lighter disease and elder group has more severe disease of upper lumbar intervertebral disc protrusion.