Correlation between thoracolumbar disc degeneration and anatomical spinopelvic parameters in supine position on MRI.

Sven S Walter,Susanne Rospleszcz,Christopher L Schlett,Elke Maurer,Fabian Bamberg,Roberto Lorbeer,Gerald Hefferman,Mike Notohamiprodjo,Anette Peters,Konstantin Nikolaou,Jan Fritz

doi:10.1371/journal.pone.0252385

Sven S Walter, Susanne Rospleszcz + Show 9 more

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https://doi.org/10.1371/journal.pone.0252385

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Abstract

ObjectiveThis study aims to investigate the correlation between spinopelvic parameters in supine position (pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL)), disc degeneration and herniation of the thoracolumbar spine, as well as cardiovascular risk factors and back pain in a southern German cohort from the general population.MethodsThis study is a cross-sectional, case–control study drawn from a prospective cohort of the “Cooperative Health Research in the Region of Augsburg/Kooperative Gesundheitsforschung in der Region Augsburg” study (KORA). In total, 374 participants (mean age 56.4 ± 9.2 years; 57.8% male) from the whole-body MRI cohort (FF4) were included. All participants underwent a standardized whole-body MRI on which disc degeneration of the thoracic and lumbar spine was evaluated using a sequence adapted Pfirrmann score. PI, PT, SS and LL were measured according to the description in the literature, using sagittal imaging. Furthermore, disc bulging and protrusion were assessed. Correlations were estimated by logistic regression models providing odds ratios.ResultsMean PI was 54.0° ± 11.1°, PT 13.0° ± 5.8°, SS 40.2° ± 8.8° and LL 36.2° ± 9.6°. SS was greater in men (p<0.05) and lumbar lordosis in women (p<0.001). PT increased by 0.09° per age-year with rising age. Age was not associated with PI, SS and LL. Neither BMI, hypertension, cholesterol, lipid levels, nor physical activity were associated with PI, PT, SS or LL. Diabetes mellitus negatively correlated with SS (β = -4.19; 95%CI -7.31–1.06, p<0.01). Smaller spinopelvic parameters (PI, SS and LL) where significantly (p<0.05) correlated with an increased frequency of disc bulging, as well as a local clustering in the lumbar, but not the thoracic spine.ConclusionIn conclusion, spinopelvic parameters, measured in supine position, are significantly correlated with disc bulging alone; there is no significant correlation between supine spinopelvic parameters and disc degeneration, back pain or cardiovascular risk factors.

Highlights

There are several known risk factors for the development of intervertebral disc degeneration
Age was not associated with Pelvic incidence (PI), Sacral slope (SS) and Lumbar lordosis (LL)
Neither body mass index (BMI), hypertension, cholesterol, lipid levels, nor physical activity were associated with PI, Pelvic tilt (PT), SS or LL

Summary

Introduction

There are several known risk factors for the development of intervertebral disc degeneration. Age [1,2,3], BMI [1,4,5,6], and level of physical activity [5,7] have been shown to correlate well with the risk of spinal degeneration and low back pain. The geometric connection between sacrum and pelvis has been gaining attention as another potentially important parameter of postural control, as both the spinal profile and pelvic parameters characterize sagittal balance [14,15,16]. In contrast to the position-dependent parameters of the pelvis (PT and SS), the PI is individual for each person, correlates with age during growth, and is fixed at skeletal maturity [14,19,20,21]

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