Abstract
Objectives: To establish the side incidence of acute lumbar disc prolapse and to determine whether there is a correlation between the side of the prolapse and hand dominance.
Design: A retrospective study of consecutive cases of acute lumbar disc prolapse in which the diagnosis was confirmed at operation and the patients contacted about hand dominance.
Summary of background data: The side incidence of operatively confirmed disc herniation does not appear to have been reported.
Lifting and turning with the trunk in the flexed position is the commonest cause of an acute disc prolapse. Flexion and rotation of the lumbar spine, under load, may also give rise to unilateral fractures in the lumbar spine in fast bowlers in cricket and in eighty percent of these cases the fracture occurs on the opposite side to the bowling arm (ref 1.) Given that the majority of the population (eighty nine percent) are right handed it was speculated that the incidence of lumbar disc prolapse might not be equal and might be greater on the side opposite the dominant hand.
Methods: From a review of case notes one hundred and twenty six patients were identified in which a sequestrated disc fragment was confirmed at operation. The side of the prolapse was noted. These patients were contacted to determine their hand dominance.
Results: Fifty nine patients (47%) had a disc prolapse on the right side and sixty seven (55%) had a disc prolapse on the left side. There was no statistically significant difference in the numbers.
Ninety two of the one hundred and twenty six patients contacted about their hand dominance responded: eighty three patients (90.2%) were right handed, eight (8.7%) were left handed and one patient (1.1%) was ambidextrous. Of the eighty three right handed patients, forty (48.2%) had a left sided disc prolapse and forty three (51.8%) had a right sided disc prolapse.
Conclusion: This study revealed no difference in the side incidence of lumbar disc prolapse. There was no correlation either with the side of the prolapse and hand dominance.
The findings are considered to support the view that a disc prolapse, and the side on which it occurs, is not a consequence of a single unilateral action but an end product of pre-existing disc degeneration in a midline structure.
The abstracts were prepared by Mr Peter Millner. Correspondence should be addressed to Peter Millner, Consultant Spinal Surgeon, Orthopaedic Surgery, Chancellor Wing, Ward 28 Office Suite, St James’ University Hospital, Beckett Street, Leeds LS9 7TF.
References:
1 Weatherley C R, Hardcastle P H, Foster D H, Elliott B C. Cricket. The Spine in Sports. Ed Watkins R G. 1996. Mosby 414–429 Google Scholar
