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Lumbar disc herniation: level increases with age.

Ruben Dammers1, Peter J Koehler

  • 1Department of General Surgery, University Hospital Maastricht, Maastricht, The Netherlands.

Surgical Neurology
|December 14, 2002
PubMed
Summary
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Older adults experience lumbar disc herniation at higher spinal levels. This study confirms that advancing age correlates with more cranial disc herniations, aiding in understanding patho-anatomy and recognizing syndromes.

Area of Science:

  • Neurosurgery
  • Orthopedics
  • Radiology

Background:

  • Clinical observations suggested older patients present with L4 radicular syndrome and L3-4 disc herniations.
  • This prompted an investigation into the relationship between patient age and the spinal level of herniated discs.

Purpose of the Study:

  • To investigate the correlation between patient age and the specific spinal level of lumbar disc herniations.
  • To determine if disc herniations occur at higher spinal levels in older individuals.

Main Methods:

  • Retrospective analysis of 1431 patients diagnosed with lumbar disc herniation between 1995 and 1998.
  • Correlation of mean patient age with the level of disc herniation (L5-S1, L4-5, L3-4, L2-3).
  • Statistical analysis using the Mann-Whitney U test and linear regression for correlation.

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Main Results:

  • Mean ages for herniation at L5-S1, L4-5, L3-4, and L2-3 were 44.1, 49.5, 59.5, and 59.6 years, respectively.
  • Significantly higher mean ages were observed for herniations at L4-5, L3-4, and L2-3 compared to L5-S1 (p < 0.0001).
  • A strong positive correlation (R = 0.371; p < 0.0001) was found between increasing age and more cranial disc herniation levels.

Conclusions:

  • Lumbar disc herniation demonstrates a trend towards more cranial localization with increasing patient age.
  • Findings contribute to understanding the patho-anatomic mechanisms of disc degeneration.
  • Results aid in recognizing higher-level radicular syndromes in elderly patients.