Sex- and age-specific distributions of intervertebral disc morphology on T2-weighted MR imaging: a population-based study.
Authors
Affiliations (25)
Affiliations (25)
- Department of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany.
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany.
- Institut für KI und Informatik in der Medizin, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
- Institute of Medical Epidemiology, Biometrics and Informatics, Medical Faculty of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany.
- Helmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Heidelberg, Germany.
- Department for Diagnostic und Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine-University of Freiburg, Freiburg, Germany.
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
- Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
- Saarland Cancer Registry, Saarbrücken, Germany.
- Cancer Prevention Graduate School, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Department Epidemiological Methods and Etiological Research, Bremen, Germany.
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany.
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany.
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
- Department of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany. [email protected].
Abstract
To perform a large-scale, automated morphometric analysis of intervertebral discs and characterize age- and sex-specific distributions of intervertebral disc (IVD) height, diameter, volume, and signal intensity in adults aged 19-74 years using T2-weighted MR imaging. Sagittal T2-weighted MR images from 30,927 participants of the German National Cohort (NAKO) were analyzed. Participants with back pain or osteoporosis were excluded. Intervertebral discs were segmented using a validated machine learning-based algorithm (SPINEPS). Morphometric parameters (IVD height, diameter, volume, and signal intensity) were extracted and analyzed separately for the cervical, thoracic, and lumbar spine. Analyses were stratified by sex and predefined age groups ( < 30, 30-39, 40-49, 50-59, ≥ 60 years). Multivariable fractional polynomial regression models were used to assess associations with age, body height, and body weight. After exclusion, 22,979 adults remained (13,307 men, 9672 women; mean age 47.0 ± 12.5 years). Across all spinal regions, IVD height, diameter, and volume were higher in men than in women. Increasing age was associated with progressive reduction in IVD height, volume, and signal intensity, accompanied by an increase in IVD diameter. Higher body weight was associated with increased IVD signal intensity in the lower cervical spine, whereas an inverse association was observed in the lower lumbar spine. Using automated, large-scale MRI, this study characterizes age- and sex-specific distributions of intervertebral disc morphology in a large population-based cohort. These findings provide a comprehensive, normative reference of age- and sex-specific distributions of intervertebral disc morphology across the cervical, thoracic, and lumbar spine, offering a framework to support clinical interpretation, spine research, and surgical planning. Question What are the age- and sex-specific distributions of intervertebral disc morphology across the cervical, thoracic, and lumbar spine in a large population-based adult cohort? Findings Men exhibited higher disc height, diameter, and volume than women. Increasing age reduced disc height, volume, and signal intensity, while disc diameter increased. Clinical relevance These population-based data provide descriptive distributions of intervertebral disc morphology, supporting spine imaging interpretation and future clinical, epidemiological, and research applications.