The Impact of the Placement of the L5 Vertebra in Relation to the Intercrest Line on the Level of Disc Herniation

Turk Neurosurg. 2024;34(3):514-520. doi: 10.5137/1019-5149.JTN.45975-23.2.

Abstract

Aim: To determine whether there is a correlation between a deeply seated L5 vertebra in relation to the intercrest line (ICL) and the level of degeneration of lumbar discs.

Material and methods: The study included 152 patients who underwent surgery for lumbar disc herniation. After analyzing the radiographs, the patients were separated into two groups. Group 1 patients had an ICL that passed through the L4 corpus, and Group 2 patients had an ICL that passed through the L4-5 disc distance or the L5 vertebra. Group 1 patients were classified as having a deeply seated L5 vertebra, while Group 2 patients were classified as not having a deeply seated L5 vertebra.

Results: The study found that male patients had a significantly higher incidence of a deeply seated L5 vertebra compared to female patients (p=0.003). Patients who underwent surgery at the L4?5 level exhibited disc heights that were notably higher than those who underwent surgery at the L5-S1 level. In Group 1, 68% of the patients had surgery at the L4-5 level, compared to only 41.7% in Group 2 (p=0.009).

Conclusion: When investigating the effects of the position of the L5 vertebra in relation to the ICL at the L4-5 and L5-S1 disc levels, the study found that having a deeply seated L5 vertebra protected against L5-S1 disc herniation and that L4-5 disc herniation was more common in these patients. This is believed to be due to the L5?S1 segment being less mobile when the L5 vertebra is deeply seated.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / pathology
  • Intervertebral Disc / surgery
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / surgery
  • Intervertebral Disc Displacement* / diagnostic imaging
  • Intervertebral Disc Displacement* / surgery
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / surgery
  • Male
  • Middle Aged
  • Radiography