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ORIGINAL PAPER
The influence of lumbar degenerative disc disease with disc herniation on the range of movements in the hip joints
Online publication date: 2009-10-19
Reumatologia 2009;47(4):223-229
KEYWORDS
ABSTRACT
Background: The study was to assess the influence of lumbar degenerative disc disease (DDD) with disc herniation on the range of passive and active movements in the hip joints. There are undoubtful biomechanical interdependences between hip joints and lumbar spine present also in pathological states. Recognition of those relationships could influence therapeutic procedures.
Material and methods: Study material consisted of 160 randomly assigned patients suffering from lumbar DDD with disc herniation and radicular pain syndrome. The diagnosis was confirmed by spinal MRI in every case. Passive and active movements in the hip joint on the side of radicular pain and on the opposite side were assessed with hand goniometer. The measurement of muscle strength in the hip joint was performed with use of chair measuring apparatus. Condition of hip joints was assessed by radiological examinations. Results were sorted according to the body side and duration of radicular pain syndrome as well as the level of lumbar hernia.
Results: On the side of radicular pain there was decrease in range of passive extension (on average 10.85° at the painful side and 13.25° on the opposite side) and active extension (8.41° and 10.15°, respectively) as well as in range of passive abduction (33.1° and 36.4°, respectively). Muscle strength of hip joint abductors was significantly lower on the side of radicular syndrome (126.5 N on the side of radicular syndrome and 151 N on the opposite side, p < 0.0001). Osteophytes on the acetabular edge were more frequent and larger on the side of radicular syndrome – they were present in 37% of persons and their mean size was 4.9 mm in comparison to the respective values of 23% and 2.6 mm on the opposite side.
Conclusions: 1. Lumbar DDD with disc herniation decreases range of movements in the hip joints. 2. Decrease in range of movement and muscle strength in the hip is observed on the side of radicular pain syndrome and increases with duration of the syndrome. These facts confirm pathogenic influence of lumbar DDD with disc herniation on the hip joint function and structure.
Material and methods: Study material consisted of 160 randomly assigned patients suffering from lumbar DDD with disc herniation and radicular pain syndrome. The diagnosis was confirmed by spinal MRI in every case. Passive and active movements in the hip joint on the side of radicular pain and on the opposite side were assessed with hand goniometer. The measurement of muscle strength in the hip joint was performed with use of chair measuring apparatus. Condition of hip joints was assessed by radiological examinations. Results were sorted according to the body side and duration of radicular pain syndrome as well as the level of lumbar hernia.
Results: On the side of radicular pain there was decrease in range of passive extension (on average 10.85° at the painful side and 13.25° on the opposite side) and active extension (8.41° and 10.15°, respectively) as well as in range of passive abduction (33.1° and 36.4°, respectively). Muscle strength of hip joint abductors was significantly lower on the side of radicular syndrome (126.5 N on the side of radicular syndrome and 151 N on the opposite side, p < 0.0001). Osteophytes on the acetabular edge were more frequent and larger on the side of radicular syndrome – they were present in 37% of persons and their mean size was 4.9 mm in comparison to the respective values of 23% and 2.6 mm on the opposite side.
Conclusions: 1. Lumbar DDD with disc herniation decreases range of movements in the hip joints. 2. Decrease in range of movement and muscle strength in the hip is observed on the side of radicular pain syndrome and increases with duration of the syndrome. These facts confirm pathogenic influence of lumbar DDD with disc herniation on the hip joint function and structure.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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