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Analysis of Migration Patterns of Disk Fragments and Contributing Factors in Extruded Lumbar Disk Herniation

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Author(s)
Eun-Seok SonDu Hwan KimJae Won JungDonggyu Lee
Keimyung Author(s)
Son, Eun SeokKim, Du HwanLee, Dong Gyu
Department
Dept. of Rehabilitation Medicine (재활의학)
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
PM & R
Issued Date
2017
Volume
9
Issue
1
Abstract
Background: The exact location of migrated extruded lumbar disk fragments is an important consideration in selecting a
treatment plan. However, few descriptive reports of the migration pattern of extruded lumbar disk fragments are available.
Objective: To examine the distribution of disk fragments and possible contributing factors that affect their migration.
Design: Retrospective descriptive study.
Setting: Tertiary university outpatient and inpatient clinic.
Patients: A total of 164 patients diagnosed with a symptomatic extruded lumbar disk from January 2011 to December 2012.
Methods: Lumbar spine magnetic resonance imaging scans of patients were retrospectively reviewed. The term “migration” was
defined as the horizontal and vertical displacement of extruded material away from the opening in the annulus through which the
material has extruded. Migration of the disk material was recorded in both the horizontal and vertical plane. In the horizontal
plane, migration was recorded as central, paracentral, subarticular, or foraminal. In the vertical plane, migration was recorded as
rostral or caudal.
Main Outcome Measurements: The pattern of migration and the associated factors (age and the level of herniation) were analyzed.
Results: Rostral and caudal migration was observed in 27% (95% confidence interval [CI], 21%-35%) and 73% (95% CI, 66%-79%) of the
patients. Central, paracentral, subarticular, and foraminal migration was observed in 6% (95% CI, 3%-11%), 67% (95% CI, 60%-74%),
18% (95% CI, 13%-25%), and 9% (95% CI, 5%-14%) of the patients, respectively. A significant increase was observed in the incidence
of rostral migration with increasing age (P ¼ .048). A significant association was also noted between migration in the horizontal
plane and increasing age (P ¼ .01). A significant increase occurred in the incidence of foraminal extrusion with increasing age
(P ¼ .01). A significant association was found between migration in the vertical plane and horizontal plane; in patients with
foraminal herniations, migration was always rostral (P < .001).
Conclusion: The migration of extruded lumbar disk materials follows some general patterns. The results of this study may help
spine interventionists and surgeons choose appropriate treatments for patients who have radiculopathy associated with lumbar
disk extrusions.
Keimyung Author(s)(Kor)
김두환
손은석
이동규
Publisher
School of Medicine
Citation
Eun-Seok Son et al. (2017). Analysis of Migration Patterns of Disk Fragments and Contributing Factors in Extruded Lumbar Disk Herniation. PM & R, 9(1), 15–20. doi: 10.1016/j.pmrj.2016.06.007
Type
Article
ISSN
1934-1482
Source
https://www.sciencedirect.com/science/article/pii/S1934148216301836?via%3Dihub
DOI
10.1016/j.pmrj.2016.06.007
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32842
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
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