Eur J Radiol. 2026 Mar 15;203:112755. doi: 10.1016/j.ejrad.2026.112755. Online ahead of print.
ABSTRACT
CONTEXT: There is little published population-based information on variations in the anatomical dimensions of lumbar and thoracic intervertebral discs observed in lateral projection.
PURPOSE: To document the simplified anatomy in lateral projection of intervertebral discs and its association with disability or disease in twenty-four male and female European Populations aged over fifty years.
STUDY SETTING: Within the published European Prospective Osteoporosis Study of Vertebral deformities and fractures.
PATIENT SAMPLES: population-based samples of 10,026 men and women aged over fifty years from fourteen European centres.
OUTCOME MEASURES: dimensional and dimension-free measures from lateral radiographs of the anatomical characteristics of three lumbar and six thoracic intervertebral discs per subject, retrieved trigonometrically from previous digitisations of vertebral body heights measured twice per subject (after excluding subjects with interval vertebral fractures). Each subject also completed at recruitment a nurse-supervised questionnaire that included questions about self-assessed health (5-point scale) and activities of daily living (3-level, 12-point scale).
METHODS: Each participant had two interval lateral radiographs of the thoracic and lumbar spine. Six thoracic discs between thoracic vertebra (T) 4 and T9 and three lumbar discs between L1 and L4 were measured. Disc dimensions were adjusted for magnification when tube-film distance was known. Associations were evaluated between anatomical disc characteristics and the self-reported health outcomes quality of life and activities of daily living.
RESULTS: After adjustment for magnification, there were large variations between populations (as well as between participants) in the disc dimensions anterior, mid- and posterior disc height as well as width. The calculated dimension-free disc indices aspect ratio, wedge angle and convexity also varied significantly between countries as well as between subjects. Indices of spine sinuosity (curvature in the AP plane) calculated separately for discs and vertebrae also varied between countries; whereas sex had smaller effects on sinuosity after allowing for differences in body size between men and women. In contrast to vertebral fractures, none of these dimension-free vertebral disc indices was significantly associated with self-assessed quality of life or activities of daily living in men and women, even when restricted to those over 65 years of age.
CONCLUSIONS: These data showed substantial variations across the continent in the geometric characteristics of the inter-vertebral discs that have implications for future study design. These variations associated more with geographic location than with sex or age. Variations in radiological disc anatomy had no significant statistical associations with two widely used health indices in those over (or under) 65 years.
ADVANCES IN KNOWLEDGE: This is the first large scale descriptive population-based multi-centre anatomical study of admittedly simplified European intervertebral disc anatomy. Its main implications are that the dimensional measures studied vary geographically and (within the ranges commonly encountered) are not common determinants of disability in older people. Nevertheless, for future anatomical case-control studies of intervertebral disc disease, it would be wise to recruit controls who are geographically local to cases to avoid statistical confounding.
PMID:42365740 | DOI:10.1016/j.ejrad.2026.112755
