Janet A. Deane
Is intrinsic lumbar spine shape associated with lumbar disc degeneration? An exploratory study.
Deane, Janet A.; Pavlova, Anastasia V.; Lim, Adrian K.P.; Gregory, Jennifer S.; Aspden, Richard M.; McGregor, Alison H.
Authors
Dr Anastasia Pavlova a.pavlova1@rgu.ac.uk
Research Fellow
Adrian K.P. Lim
Jennifer S. Gregory
Richard M. Aspden
Alison H. McGregor
Abstract
Background: Lumbar disc degeneration (LDD) is a condition associated with recurrent low back pain (LBP). Knowledge regarding effective management is limited. As a step towards the identification of risk, prognostic or potentially modifiable factors in LDD patients, the aim of this study was to explore the hypothesis that intrinsic lumbar spine shape is associated with LDD and clinical outcomes in symptomatic adults. Methods: 3 T MRI was used to acquire T2-weighted sagittal images (L1-S1) from 70 healthy controls and LDD patients (mean age 49 years, SD 11, range 31-71 years). Statistical Shape Modelling (SSM) was used to describe lumbar spine shape. SSM identified variations in lumbar shape as 'modes' of variation and quantified deviation from the mean. Intrinsic shape differences were determined between LDD groups using analysis of variance with post-hoc comparisons. The relationship between intrinsic shape and self-reported function, mental health and quality of life were also examined. Results: The first 7 modes of variation explained 91% of variance in lumbar shape. 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 of recurrent LBP, LDD was associated with a larger A-P vertebral diameter (Mode 3) and a more even lumbar curvature with smaller L5/S1 disc spaces (Mode 4), which was significantly associated with patient quality of life (P = 0.002-0.04, rp = 0.43-0.61)). Conclusions: This exploratory study provides new evidence that intrinsic shape phenotypes are associated with LDD and quality of life in patients. Longitudinal studies are required to establish the potential role of these risk or prognostic shape phenotypes.
Citation
DEANE, J.A., PAVLOVA, A.V., LIM, A.K.P., GREGORY, J.S., ASPDEN, R.M. and MCGREGOR, A.H. 2020. Is intrinsic lumbar spine shape associated with lumbar disc degeneration? An exploratory study. BMC musculoskeletal disorders [online], 21, article number 433. Available from: https://doi.org/10.1186/s12891-020-03346-7
Journal Article Type | Article |
---|---|
Acceptance Date | May 13, 2020 |
Online Publication Date | Jul 3, 2020 |
Publication Date | Dec 31, 2020 |
Deposit Date | Jul 27, 2021 |
Publicly Available Date | Jul 27, 2021 |
Journal | BMC Musculoskeletal Disorders |
Electronic ISSN | 1471-2474 |
Publisher | Springer |
Peer Reviewed | Peer Reviewed |
Volume | 21 |
Article Number | 433 |
DOI | https://doi.org/10.1186/s12891-020-03346-7 |
Keywords | Low back pain; Lumbar disc degeneration; Quality of life; MRI; Statistical shape modelling |
Public URL | https://rgu-repository.worktribe.com/output/1380388 |
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© 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
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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.
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