Is intrinsic lumbar spine shape associated with Lumbar Disc Degeneration? An exploratory study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: Lumbar disc degeneration (LDD) is a condition associated with recurrentlow back pain (LBP). Knowledge regarding effective management is limited. As a steptowards the identification of risk, prognostic or potentially modifiable factors in LDDpatients, the aim of this study was to explore the hypothesis that intrinsic lumbar spineshape is associated with LDD and clinical outcomes in symptomatic adults. Methods: 3T MRI was used to acquire T2-weighted sagittal images (L1-S1) from 70healthy controls and LDD patients (mean age 49 years, SD 11, range 31-71years). Statistical Shape Modelling (SSM) was used to describe lumbar spine shape.SSM identified variations in lumbar shape as ‘modes’ of variation and quantifieddeviation from the mean. Intrinsic shape differences were determined between LDDgroups using analysis of variance with post-hoc comparisons. The relationshipbetween intrinsic shape and self-reported function, mental health and quality of lifewere also examined.Results: The first 7 modes of variation explained 91% of variance in lumbarshape. Higher LDD sum scores correlated with a larger lumbar lordosis (Mode 1 (55%variance), P=0.02), even lumbar curve distribution (Mode 2 (12% variance), P=0.05),larger anterior-posterior (A-P) vertebral diameter (Mode 3 (10% variance), P=0.007)and smaller L4-S1 disc spaces (Mode 7 (2% variance), P≤0.001). In the presence ofrecurrent LBP, LDD was associated with a larger A-P vertebral diameter (Mode 3) anda more even lumbar curvature with smaller L5/S1 disc spaces (Mode 4), which wassignificantly associated with patient quality of life (P=0.002-0.04, r p =0.43-0.61)).Conclusions: This exploratory study provides new evidence that intrinsic shapephenotypes are associated with LDD and quality of life in patients. Longitudinalstudies are required to establish the potential role of these risk or prognostic shapephenotypes.
Date Acceptance
2020-04-13
Citation
BMC Musculoskeletal Disorders, 21 (433), pp.1-10
ISSN
1471-2474
Publisher
BioMed Central
Start Page
1
End Page
10
Journal / Book Title
BMC Musculoskeletal Disorders
Volume
21
Issue
433
Copyright Statement
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article's Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article's Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.
License URL
Sponsor
Arthritis Research UK
Identifier
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03346-7
Subjects
Low back pain
Lumbar disc degeneration
MRI
Quality of life
Statistical shape modelling
Orthopedics
1103 Clinical Sciences
Publication Status
Published
Date Publish Online
2020-07-03