A 55-year-old woman with degenerative lumbar spine disease undergoes MRI. The radiologist notes that the lumbar lordosis is maintained despite disc degeneration. Which anatomical feature of lumbar vertebral bodies contributes most to maintaining the lumbar lordotic curve?

• A Anterior wedge shape of vertebral bodies
• B Thicker anterior annulus fibrosus compared to posterior ✓
• C Attachment of the anterior longitudinal ligament
• D Orientation of facet joints in the sagittal plane

Explanation

The lumbar lordosis is maintained partly because the anterior portion of the intervertebral disc is thicker than the posterior portion, with the annulus fibrosus being thicker anteriorly. This disc asymmetry contributes to the normal lumbar lordotic curve. Loss of disc height anteriorly, as in degenerative disease, can reduce lordosis. The facet joints in the lumbar spine are oriented more in the sagittal plane but this primarily affects motion rather than static curvature.

Reference: Bogduk: Clinical and Radiological Anatomy of the Lumbar Spine, 5th ed.

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Written and medically reviewed by the StethoPrep medical team.