Intervertebral disc status is associated with vertebral marrow adipose tissue and muscular endurance
Low back pain is a major public health issue. Identifying factors associated with better intervertebral disc (IVD) characteristics gives insight into IVD metabolism and highlights intervention targets for improvement of IVD health. This cross-sectional study investigates whether IVD T2-relaxation time on magnetic resonance imaging (MRI) is associated with vertebral fat fraction (VFF; to quantify marrow adipose tissue), trunk muscle cross-sectional area (CSA), muscle function and physical activity (PA).
Seventy-nine healthy subjects (35 males, 44 females) without history of spinal disease were included. Lumbar IVDs T2-relaxation time, lumbar VFF and CSA of multifidus, erector spinae, quadratus lumborum, and psoas muscles were quantified via MRI. Isometric trunk flexion and extension endurance times as well as habitual PA levels and exposure to occupational spine risk factors were documented. Pearson-partial correlations adjusted for anthropometric differences by controlling for vertebral body height.
Higher IVD T2-time correlated with: (a) lower VFF (r = − 0.27, p < 0.05), (b) greater trunk extensor muscle endurance (r = 0.37, p < 0.01), and (c) greater trunk flexor muscle endurance (r = 0.30, p < 0.01) but not with muscle CSA. Lower VFF also correlated with greater extensor muscle endurance (r = − 0.26, p < 0.05) and habitual PA (MET-mins per week) (r = − 0.24, p < 0.05).
This is the first study to show that better IVD hydration is associated with lower VFF and that greater physical activity is associated with favourable levels of vertebral marrow adipose tissue in young healthy individuals. Reduced vertebral marrow adipose tissue may specifically improve IVD hydration via improved nutrient supply.
KeywordsIntervertebral disc Exercise Marrow adipose tissue Magnetic resonance imaging Muscular endurance
The authors wish to thank the individuals who participated in this study, the staff at Imaging@OlympicPark, and the colleagues involved in the implementation of the Spine and Physical Activity Study.
Compliance with ethical standards
Conflict of interest
All authors declare they have no conflicts of interest.
IRB approval/research ethics committee
Deakin University Human Ethics Advisory Group.
- 13.Vrselja Z, Curic G (2017) Vertebral marrow adipose tissue adipokines as a possible cause of intervertebral disc inflammation. Jt Bone Spine (epub ahead of print) Google Scholar
- 20.Belavý DL, Quittner MJ, Ridgers ND et al (2018) Specific modulation of vertebral marrow adipose tissue by physical activity. J Bone Miner Res (epub ahead of print) Google Scholar
- 23.NIOSH (1997) Low-back musculoskeletal disorders: evidence for work-relatedness. In: Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back (Internet). National Institute for Occupational Safety and Health, chap 6. https://www.cdc.gov/niosh/docs/97-141/. Accessed 15 Dec 2016