Pathological manifestations of lateral radiographs of lumbar vertebrae in patients with lumbar disc herniation?

The following signs can often be seen on the lateral films of patients with lumbar disc herniation.

Changes of physiological lordosis of lumbar spine (1). The physiological curvature of lumbar spine can disappear, and kyphosis opposite to normal kyphosis can appear in severe cases. This is because the protective response reduces the compression on nerve roots and dura mater.

(2) Changes of lumbar intervertebral space. On the lateral radiograph of patients with lumbar disc herniation, except the lumbar 5 and sacral 1 intervertebral space, it can be shown that the next space is narrower than the last one. In the early stage, the intervertebral space was narrow before and wide after, and in the middle and late stage, the intervertebral space was obviously narrowed, that is, the fibrous ring was broken and the nucleus pulposus was herniated.

(3) Bone hyperplasia at the anterior edge of upper and lower vertebral bodies. Due to intervertebral disc degeneration, the adjacent vertebral bodies move abnormally, resulting in osteophyte, which is also one of the pathological changes of intervertebral disc herniation.

(4) The intervertebral foramen becomes smaller. This is because the superior articular process of the lower vertebral body is staggered upward after disc herniation. If the superior joint invades the inferior notch of pedicle, it may be embedded in the nerve root running in it.

(5) Calcification and hyperplasia near the posterior edge of lumbar spine. This means old disc injury or protrusion. Calcification of nucleus pulposus will cause the symptoms of stiff lumbar movement, and calcification will definitely reduce the volume of spinal canal and induce the signs of nerve root compression.