Abstract
This exploratory study investigates the association between imaging findings, clinical symptoms and gait parameters in patients with lumbar disc herniation (LDH). To explore this hypothesis, this study aims (1) to study how IVD height and intervertebral angle measurements obtained from MRI compare with those obtained from X-ray imaging; (2) to compare spatiotemporal gait parameters between LDH patients and healthy individuals and (3) to study if gait parameters vary in relation to clinical and imaging-derived measurements in LDH patients. Patients in this study underwent lumbar spine X-ray imaging and MRI, completed the Oswestry Disability Index (ODI) and Numerical Pain Rating Scale (NPRS) and participated in a gait analysis assessment. Measurements of IVD height and intervertebral angle revealed unexpected higher values in X-ray scans when compared to MRI, particularly in anterior IVD height and upper lumbar levels, providing important hints for the analysis of the initial imaging exam (usually X-ray scan). In addition, the analyzed gait parameters were altered in most LDH patients, with reduced walking speed, cadence, stride length and single support time and increased double support time, comparatively to healthy controls. A general tendency was found between intense radicular pain and high disability (NPRS and ODI scores, respectively) – both reflecting the impact of the clinical condition – and significant IVD pathology – evident on imaging – and altered gait parameters. However, some cases showed inconsistencies between clinical symptoms, imaging findings and gait parameters, suggesting that the relationship between the mentioned parameters is not always consistent. These findings underscore the importance of a multidimensional approach in evaluating LDH biomechanics, integrating clinical and gait parameters, while identifying potential discrepancies between imaging modalities for better initial assessment and follow-up.