J Korean Radiol Soc.  1982 Dec;18(4):803-810. 10.3348/jkrs.1982.18.4.803.

Plain radiographic findings of L5/S1 disc herniation and the significance of L5/S1 disc space narrowing

• Shin SG
• Cho IY
• Lee CJ
• Whang IS

• KMID: 2463250
• DOI: http://doi.org/10.3348/jkrs.1982.18.4.803

Abstract

To set up the criteira determining the significant plain radiographic findings suggesting L5/S1 discherniation with focusing upon L5/S1 disc space narrowing, a retrospective roentgenographic study was carried out23 patient having surgically-confirmed L5/S1 disc herniation between 18 and 57 years old. Considering the uniquestructural and functional characteristics, normal and pathological anatomy of the lumbosacral junction was alsoreviewed briefly. This paper also re-evaluated and re-lightened the importance to interprete plain lumbosacralroentgenogram more carefully and accurately. For it will certainly serve as the initial screening method toidentify the region of concern for the recently thriving Spine CT for rapid, non-invasive ,efffective diagnosis ofthe universal disaster-lumbar disc herniation. We have obtained the following conclusions; 1. The method tointerpret as "positive " L5/S1 disc space narrowing when the central height of L5/S1 disc space is reduced belowthe central height of L3/4 showed the highest correlation(approximately;70%) with disc herniation, especially inthe lower age group below forty(76.9%). 2. The diagnostic significance of L5/S1 disc space narrowing as a roentgensign suggesting L5/S1 disc herniation is increasing as the more following items are satisfied; a. When thelong-standing symptom and neurologic signs suspecting S1 nerve root compression or irritation are present. b. Whenthe patient is among the lower age group, such as below forty. c. When there is no vertebral lesion causing spinalinstability. d. When there are additional findings suggsting L5/S1 disc herniation, especially if they are limitedat L5/S1 level. 3. Other conditions having L5/S! disc space narrowing are the anatomically narrow lumbosacraljunction with or without transitional vertebra, the infectious narrowing, the degenerative narrowing without disc herniation, and the isolated disc herniation. Those can be usually differentiated from L5/S1 disc herniation by their different clinical featuresand plain radiographic findings.

MeSH Terms

Diagnosis
Humans
Mass Screening
Methods
Neurologic Manifestations
Radiculopathy
Retrospective Studies
Spine