Laterality of lumbar disc herniation
Laterality of lumbar disc herniation
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DOI：
10.1016/j.jos.2022.10.003
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发表时间：
2023-11-20
影响因子：
1.7
通讯作者：
Imagama, Shiro
中科院分区：
文献类型：
--
作者：
Ito, Sadayuki;Nakashima, Hiroaki;Imagama, Shiro
背景：腰椎间盘突出症(LDH)最常见于20-40岁男性的L4/5节段；然而，尚未有左右差异的报道。提高我们对左侧和右侧腰椎脱位的了解，可能有助于估计椎间盘的机械负荷。方法：在名古屋脊柱组数据库中确定的10,972例腰椎脱位的手术病例中，2899例在单个椎体节段内可见左右两侧的腰椎脱位(平均年龄46.3±16.6岁，2028名男性)。结果：右腰椎脱位1358例，左侧腰椎脱位1 541例，右侧腰椎脱位患者明显高于左侧腰椎脱位患者(P<；0.001)。两组间在性别、年龄、LDH水平、手术方法、手术时间、出血量、住院时间、术前JOA评分或JOA恢复率方面均无差异。右侧LDH的发生率随年龄增长而增加，10~29岁、30~49岁、50~69岁、70~89岁患者的发生率分别为42.7%、45.1%、49.9%、54.7%。没有观察到关于症状、治疗或结果的组间差异。(C)2022年日本整形外科协会。爱思唯尔出版，版权所有。
Background: Lumbar disc herniation (LDH) is most common in men aged 20-40 at the L4/5 level; however, left-right differences have not been reported. Improving our understanding of left- and right-side LDH may facilitate the estimation of mechanical load on intervertebral discs. Here, we assessed left-right differences in LDH via a retrospective analysis of LDH cases.Methods: Among 10,972 surgical cases of LDH identified in the Nagoya Spine Group database, 2899 in which right- and left-LDH sides were observable in a single vertebral segment were identified (mean age 46.3 +/- 16.6 years, 2028 males). The following characteristics of patients with right- and left-LDH were compared: age, LDH level, surgical technique, operative time, blood loss, length of hospital stay, preoperative Japan Orthopaedic Association (JOA) score, and JOA recovery rate.Results: LDH occurred on the right and left sides in 1358 and 1541 patients, respectively, with patients with right-side LDH significantly older than those with left (47.9 +/- 16.6 versus 45.0 +/- 16.5, respectively; p < 0.001). No between-group differences in sex, age, LDH level, surgical technique, operative time, blood loss, length of hospital stay, preoperative JOA score, or JOA recovery rate were observed. The occurrence of right-side LDH increased with age, occurring in 42.7%, 45.1%, 49.9%, and 54.7% of patients aged 10-29, 30-49, 50-69, and 70-89 years, respectively.Conclusion: Left-side LDH was observed more frequently than right; however, right-side LDH incidence increased with age. No significant between-group differences regarding symptoms, treatments, or outcomes were observed.(c) 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.