STUDY DESIGN: A cross-sectional case-control study was designed to compare the sagittal alignment of lumbosacral regions in two groups of patients suffering from low back pain, one with intervertebral disc pathologies and one without. PURPOSE: To evaluate the correlation between lumbosacral sagittal alignment and disc degeneration. OVERVIEW OF LITERATURE: Changes in lumbar lordosis and pelvic parameters in degenerative disc lesions have been assessed in few studies. Overall, patients with discopathy were shown to have lower lumbar lordosis and more vertical sacral profiles. METHODS: From patients with intractable low back pain undergoing lumbosacral magnetic resonance imaging, 50 subjects with disc degeneration and 50 controls with normal scans were consecutively enrolled. A method was defined with anterior tangent-lines going through anterior bodies of L1 and S1 to measure global lumbosacral angle, incorporating both lumbar lordosis and sacral slope. Global lumbosacral angle using the proposed method and lumbar lordosis using Cobb's method were measured in both groups. RESULTS: Lumbar lordosis based on Cobb's method was lower in group with discopathy (20degrees-67degrees; mean, 40.48degrees+/-9.89degrees) than control group (30degrees-62degrees; mean, 44.96degrees+/-7.68degrees), although it was not statistically significant. The proposed global lumbosacral angle in subject group (53degrees-103degrees; mean, 76.5degrees+/-11.018degrees) was less than control group (52degrees-101degrees; mean, 80.18degrees+/-9.95degrees), with the difference being statistically significant (p=0.002). CONCLUSIONS: Patients with intervertebral disc lesions seem to have more straightened lumbosacral profiles, but it has not been proven which comes first: disc degeneration or changes in sagittal alignment. Finding an answer to this dilemma demands more comprehensive long-term prospective studies.
Animals ; Case-Control Studies ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Lordosis ; Low Back Pain ; Lumbosacral Region ; Magnetic Resonance Imaging ; Pathology

Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.
Adult ; Brain ; Eosinophils ; Epithelioid Cells ; Extracellular Matrix ; Female ; Glioma* ; Headache ; Humans ; Hypothalamus ; Mucins ; Optic Chiasm ; Optic Nerve ; Periodic Acid ; Third Ventricle*