[The physiological pattern of lumbar intervertebral disk height].
Purpose of this study is to present a new method of quantifying objectively the height of all discs in lateral radiographs of the lumbar spine and of analysing the normal craniocaudal sequence pattern of lumbar disc heights.


METHODS
The new parameter is the ventrally measured disc height corrected for the dependence on the angle of lordosis by normalisation to mean angles observed in the erect posture of healthy persons. To eliminate radiographic magnification, the corrected ventral height is related to the mean depth of the cranially adjoining vertebra. In this manner lumbar disc heights were objectively measured in young, mature and healthy persons (146 males and 65 females). The craniocaudal sequence pattern was analysed by mean values from all persons and by height differences of adjoining discs in each individual lumbar spine.


RESULTS
Mean normative values demonstrated an increase in disc height between L1/L2 and L4/L5 and a constant or decreasing disc height between L4/L5 and L5/S1. However, this "physiological sequence of disc height in the statistical mean" was observed in only 36% of normal males and 55% of normal females.


CONCLUSIONS
The radiological pattern of the "physiological sequence of lumbar disc height" leads to a relevant portion of false positive pathological results especially at L4/L5. An increase of disc height from L4/L5 to L5/S1 may be normal. The recognition of decreased disc height should be based on an abrupt change in the heights of adjoining discs and not on a deviation from a craniocaudal sequence pattern.
Biggemann
M
M
Radiologische Klinik, Evangelisches Krankenhaus Bethesda, Duisburg.
Frobin
W
W
Brinckmann
P
P
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008297:Male; D011856:Radiographic Image Enhancement; D012016:Reference Values; D012727:Sex Characteristics