lumbar

Epidemiology

Sciatica > 2/52 1.6%

M:F = 1:1

Most common L4/5 

L5/S1 inherently stable 

Risk factors

Sedentary lifestyle

Smokers

Frequent driving

Heavy lifting 

Anatomy

Annulus Fibrosis

- circumferential, multilayered rim

Definition

Diffuse Idiopathic Skeletal Hyperostosis

- non-inflammatory disease

- ossifying enthesopathy / bone forming diasthesis

- most commonly involves spine / anterior longitudinal ligament

AKA  Forestier's disease

DDx

Ankylosing Spondylosis

DISH

- non inflammatory

- no facet or SIJ involvement

- no squaring of anterior vertebral body