Development of normalized quantitative measures of lumbar disc degeneration

IF 3.4 3区 医学 Q1 ORTHOPEDICS JOR Spine Pub Date : 2023-09-12 DOI:10.1002/jsp2.1278
Samuel King, John Magnussen, James Elliott, Mark Jonathan Hancock
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Abstract

Background

Lumbar disc degeneration (DD) is widely regarded as a likely contributor to low back pain (LBP), but the association between DD and LBP is relatively weak. No known studies have normalized quantitative measures of DD severity relative to multiple variables such as age, height, and disc level. This study developed normalized quantitative measures (z-scores) of disc signal intensity (DSI) and disc height (DH) to rate relative severity of DD.

Methods

Raw (unnormalized) quantitative measures of DSI and DH alongside potential normalization variables were acquired from MRI scans and clinical data of 76 patients. The associations between the raw quantitative measures and potential normalization variables were investigated to develop the normalized quantitative measures (z-scores) of DSI and DH. Construct validity was assessed by comparing the normalized measures to an experienced radiologist's subjective measures of relative severity of DSI and DH loss.

Results

CSF signal intensity, age, and disc level were significantly associated with raw DSI (R2 = 0.06, 0.25, and 0.09, respectively). Lumbar height and disc level were significantly associated with raw DH (R2 = 0.13 and 0.31). Normalizing DSI and DH by these variables resulted in stronger relationships (R2 = 0.39 and 0.37) than raw DSI and DH (R2 = 0.24 and 0.31) with the radiologist's subjective measures. Normalized DSI and DH were both normally distributed (p = 0.32 and 0.12).

Conclusions

Construct validity and the distributions suggested that normalized quantitative measures of DSI and DH are better than existing measures of DSI and DH at rating relative DD severity. Determining whether normalized quantitative measures are more predictive of clinical outcomes is important future research.

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腰椎间盘退变标准化定量测量方法的发展。
背景:腰椎间盘退变(DD)被广泛认为可能是导致腰痛(LBP)的原因,但DD与LBP之间的相关性相对较弱。没有已知的研究将DD严重程度相对于年龄、身高和椎间盘水平等多个变量的定量测量标准化。本研究开发了椎间盘信号强度(DSI)和椎间盘高度(DH)的归一化定量测量(z评分),以评定DD的相对严重程度。方法:从76名患者的MRI扫描和临床数据中获得DSI和DH的原始(未归一化)定量测量值以及潜在的归一化变量。研究了原始定量测量和潜在归一化变量之间的关联,以开发DSI和DH的归一化定量测量(z分数)。通过将标准化测量与经验丰富的放射科医生对DSI和DH损失相对严重程度的主观测量进行比较来评估结构有效性。结果:CSF信号强度、年龄和椎间盘水平与原始DSI显著相关(R2 = 分别为0.06、0.25和0.09)。腰椎高度和椎间盘水平与原始DH显著相关(R2 = 0.13和0.31)。通过这些变量归一化DSI和DH导致更强的关系(R2 = 0.39和0.37)比原始DSI和DH(R2 = 0.24和0.31)。归一化DSI和DH均呈正态分布(p = 0.32和0.12)。结论:结构有效性和分布表明,DSI和DH的标准化定量测量在评定相对DD严重程度方面优于DSI和DH现有的测量。确定标准化的定量测量是否更能预测临床结果是未来重要的研究。
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来源期刊
JOR Spine
JOR Spine ORTHOPEDICS-
CiteScore
6.40
自引率
18.90%
发文量
42
审稿时长
10 weeks
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