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Association of delayed apophyseal ring maturation with juvenile lumbar disc herniation: a retrospective case-control
Siyuan Xie1, Shiguo Yuan2,3, Rui Weng4
1School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China. 13421885129@163.com.
Objective:
To investigate the association between delayed apophyseal ring (AR) maturation and juvenile lumbar disc herniation (JDH), and to characterize the associated patterns of AR separation and spatial development.
Method:
This retrospective case-control study evaluated CT scans from 180 JDH patients and 178 matched controls aged 12 to 20. We graded AR maturation (S0-S4) and assessed its association with JDH via logistic regression.
Results:
JDH patients showed significant AR maturation delays of 1-2 years compared to controls. After adjusting for age and sex, JDH remained associated with lower odds of achieving AR maturity (OR = 0.277, P < 0.001). In patients with JDH, AR separation was present in 30.8% of herniated segments, with incidence increasing significantly after age 17. Furthermore, JDH patients demonstrated altered terminal spatial patterns of AR maturation (P < 0.001).
Conclusions:
A strong association exists between delayed AR maturation and JDH. JDH patients also demonstrated altered terminal spatial patterns of AR maturation and a high incidence of AR separation after age 17. These findings suggest that JDH pathogenesis may be associated with developmental factors, highlighting the need for future research to explore these associations.
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