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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.


Janet A. Deane

Adrian K.P. Lim

Jennifer S. Gregory

Richard M. Aspden

Alison H. McGregor


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.


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:

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
Keywords Low back pain; Lumbar disc degeneration; Quality of life; MRI; Statistical shape modelling
Public URL


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