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The form and structure of the extruded disc
1Department of Neurosurgery, Klinikum Steglitz, Free University of Berlin, Germany.
Spine
|December 1, 1992
Summary
This study analyzed 100 sequestered lumbar disc herniations, finding they are more common in older patients. The histologic nature of extruded fragments varied, with many containing end-plate material, not just nucleus pulposus.
Area of Science:
- Orthopedics
- Spinal Surgery
- Histopathology
Background:
- Limited literature exists on the histologic composition and surgical frequency of sequestered lumbar discs.
- Understanding these characteristics is crucial for surgical planning and patient management.
Purpose of the Study:
- To prospectively analyze the histologic nature and surgical frequency of sequestered lumbar disc herniations.
- To compare demographic and compositional characteristics with prolapsed and protruded discs.
Main Methods:
- Prospective analysis of 100 consecutive patients undergoing surgery for sequestered lumbar disc herniation.
- Surgical data collection and histologic examination of extruded disc fragments.
- Comparison of patient demographics and fragment composition between sequestered, prolapsed, and protruded disc groups.
Main Results:
- Sequestered lumbar discs constituted 28.6% of all operated lumbar disc herniations.
- Patients with sequestered discs were significantly older than those with prolapsed or protruded discs.
- Extruded fragments were predominantly nucleus pulposus in 54 cases and end-plate material in 44 cases; multiple/recurrent fragments were mainly end-plate material.
Conclusions:
- The histologic composition of sequestered lumbar disc fragments is variable, often including end-plate material.
- Age is a significant factor differentiating sequestered discs from other herniation types.
- Findings suggest potential metabolic alterations in disc degeneration contributing to fragment composition.