A pathologic study of lumbar disc herniation in the elderly.

Area of Science:

• Orthopedics
• Pathology
• Gerontology

Background:

• Lumbar disc herniation is a common condition, particularly in older adults.
• Understanding the specific pathological components of herniated discs in the elderly is crucial for effective treatment.

Purpose of the Study:

• To pathohistologically analyze herniated lumbar disc fragments from elderly patients.
• To compare the composition of herniated discs in patients over 60 with those under 59.

Main Methods:

• Pathohistological examination of 29 herniated lumbar disc fragments from patients over 60.
• Comparative analysis with 109 discs from patients under 59.
• Classification of disc fragments into seven types based on composition.

Main Results:

• In 70% of patients aged 60-69 and 80% of patients over 70, herniated fragments included the anulus fibrosus and cartilaginous end-plate.
• The cartilaginous end-plate avulsed from the vertebral body and herniated with the anulus fibrosus.
• This type of herniation was observed more frequently than nucleus pulposus herniation in patients over 30.

Conclusions:

• Cartilaginous end-plate avulsion with the anulus fibrosus is a common herniation type in elderly patients.
• Advanced disc degeneration likely contributes to the increased prevalence of this herniation type in older individuals.
• Findings suggest a shift in herniation mechanisms with aging, emphasizing end-plate involvement.