Are There Correlations Between Disc Degeneration and the Appearance of Lumbar Disc Herniations?

作者：Linhardt O^*; Grifka J; Benditz A

来源：Zeitschrift fur Orthopadie und Unfallchirurgie, 2016, 154(6): 595-600.

DOI：10.1055/s-0042-109568

• prolapse
• chondrosis
• disc degeneration

Background: The correlation between disc prolapse and disc degeneration is important in the evaluation of clinical and occupational disease. The present clinical radiological study investigated whether there is a correlation between disc degeneration (chondrosis) and disc prolapses.
Patients and Methods: The present study is a retrospectively trial which was performed with conservatively and surgically treated patients from 2011 till 2013 in our clinic. 100 patients with disc prolapse and chondrosis in current MRI images were recruited. We classified patients into those who exhibited a prolapse and chondrosis in the same segment, those with only disc prolapse and those with only chondrosis. Statistical evaluation for the correlation between chondrosis and disc prolapse was performed with the chi-square test. Odds ratios for prolapse and chondrosis were calculated, as well as interobserver reliability (kappa-value) between the first and second observers of radiological images.
Results: In all segments in our 100 patients, 119 radiological findings were made (= 100%). 54 findings (45%) with disc prolapse in combination with chondrosis were identified in the same lumbar segment. 43 findings (36%) exhibited disc prolapse without chondrosis and 22 (19%) chondrosis without prolapse. Inmost cases, thefindings were seen in the last two segments. There was a statistical correlation between disc prolapse and chondrosis, as seen with the chi-squared test. As regards odds ratios, disc prolapse with chondrosis was 1.25-fold more frequent than prolapse without chondrosis; chondrosis with prolapse was 2.37-fold more frequent than chondrosis without prolapse. The interobserver reliability showed a kappa-value of 0.79 with disc prolapses and a kappa-value of 0.85 with chondrosis.
Conclusion: For patients with disc prolapse and chondrosis in the same segment, chondrosis was mostly seen in combination with a prolapse. A causal relation was found between prolapse and chondrosis in the same segment. The interobserver reliability showed high correlation for radiological findings with disc prolapse and very high correlations with chondrosis.

• 出版日期2016-12