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Is it appropriate to measure age-related lumbar disc degeneration on the mid-sagittal MR image? A quantitative image study

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Abstract

Purpose

Even though phenotypes of disc degeneration vary on different sagittal magnetic resonance images (MRI), measurements typically are acquired on the mid-sagittal MRI. This study investigated the appropriateness of using the mid-sagittal MRI to measure various phenotypes of age-related disc degeneration.

Methods

Lumbar spine MRIs of 66 subjects (mean age 50.3 years, standard deviation 16.5 years, range 22–84 years) were studied. An image analysis program Spine Explorer was used to obtain quantitative measurements for disc height, bulging, and signal on para- and mid-sagittal T2-weighted MRIs. Measurements on para- and mid-sagittal MRIs and their associations with age were compared.

Results

Measurements of disc height, signal, and posterior disc bulging acquired on the mid-sagittal MRI were greater than those on the para-sagittal MRIs. Disc height measurements were not linearly associated with age. Greater age was correlated with greater anterior (r = 0.45, P < 0.001) and posterior (r = 0.33, P < 0.01) bulging on para-sagittal MRIs, but not posterior disc bulging on the mid-sagittal MRI (r = − 0.10, P > 0.05). Disc signal intensity measurements on the mid-sagittal MRI had stronger correlations with age than those on para-sagittal MRIs. Mean and standard deviation of disc signal intensity acquired on the mid-sagittal MRI had the strongest correlations with age among all measures of disc degeneration studied (r = − 0.50, − 0.67, respectively, P < 0.001 for both).

Conclusions

Disc signal measurements acquired on the mid-sagittal MRI were reliable and had strong correlations with age and thus can be used as an appropriate measure of disc degeneration. Disc bulging had better be measured on para-sagittal MRIs. Although severe disc narrowing clearly is a sign of severe disc degeneration, disc height was not linearly associated with age.

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Acknowledgements

We are indebted to Ms. Ying Yuan for her tremendous work in subject recruitment and data collection. We also thank the clinic staffs at the Department of Orthopedic Surgery and Radiology at the first affiliated hospital of Zhejiang University for their assistance in conducting the Hangzhou Lumbar Spine Study.

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Authors and Affiliations

  1. Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, People’s Republic of China

    Xiaojian Hu, Mingjian Chen, Jianjiang Pan & Yue Wang

  2. The Wallace H. Coulter, Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30313, USA

    Liang Liang

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  1. Xiaojian Hu
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Correspondence to Yue Wang.

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Funding

This work was supported by the National Natural Science Foundation of China (81371995), Key Platform Project of the Health Department of Zhejiang Province (2015ZDA014) and 2015 Qianjiang Talent Plan of Zhejiang Province.

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The authors declare that they have no competing interests.

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Hu, X., Chen, M., Pan, J. et al. Is it appropriate to measure age-related lumbar disc degeneration on the mid-sagittal MR image? A quantitative image study. Eur Spine J 27, 1073–1081 (2018). https://doi.org/10.1007/s00586-017-5357-3

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