Assessment of subcutaneous fat tissue thickness as a biomarker for cervical intervertebral disc degeneration

Abstract

Cervical intervertebral disc degeneration (IVDD) is a chronic musculoskeletal disorder contributing to neck pain, often associated with mechanical instability of the disc. Obesity and increased subcutaneous fat tissue thickness (SFTT) have been identified as key risk factors for the development of IVDD. This study retrospectively analyzed 245 Turkish female patients aged 40–50 years, who presented with neck pain and underwent cervical MRI between 2022 and 2024. Patients with malignancy, prior spinal surgery, congenital anomalies, or artifacts on MRI were excluded. The severity of IVDD at the C6-C7 level was graded using the Pfirrmann system, and SFTT measurements were performed on axial T2-weighted images at the C3, C5, and C7 levels. Statistical analyses included the Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation. IVDD was absent in 29.39 % of participants, while the remaining showed varying grades of degeneration, with Grade 2 being the most common (24.08 %). Patients with disc degeneration had significantly higher SFTT at all measured levels (p < 0.001). ROC analysis identified an optimal cutoff value for SFTT at the C7 level as 22.57 mm, with 79.19 % sensitivity and 63.89 % specificity. These results indicate a positive correlation between increased SFTT and both the presence and severity of IVDD, suggesting that SFTT, particularly at the C7 level, may serve as a non-invasive biomarker for IVDD. Further multicenter research is recommended to confirm these findings.Abbreviations: AUC, Area Under the Curve; BMI, Body Mass Index; C, Cervical; IL, Interleukin; IVDD, Intervertebral Disc Degeneration; MRI, Magnetic Resonance Imaging; ROC, Receiver Operating Characteristic; SFTT, Subcutaneous Fat Tissue Thickness; T2WI, T2-Weighted Image; TNF, Tumor Necrosis Factor.