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Purpose <p>To examine associations between lumbar intervertebral disc degeneration (LDD) and type II Modic changes (MC) when retaining information at each interspace (“interspace-level analysis”), as compared to aggregating information across interspaces as is typically done in spine research (“person-level analysis”). The study compared results from (1) interspace-level analyses assuming a common relationship across interspaces (the “interspace-level, common-relationship” approach), (2) interspace-level analyses allowing for interspace-specific associations (an “interspace-level, interspace-specific” approach), (3) and a conventional person-level analytic approach.</p> Methods <p>Adults in primary care (n = 147) received lumbar spine magnetic resonance imaging and neuroradiologist-evaluated assessments of prevalent disc height narrowing (DHN), type II MC, and other LDD parameters. Analyses examined associations between DHN and type II MC in interspace-level, common-relationship analyses, interspace-level, interspace-specific analyses, and conventional person-level analyses.</p> Results <p>Cross-sectional, interspace-level, common-relationship analyses found large-magnitude DHN-type II MC associations (adjusted OR [aOR] = 6.5, 95% confidence intervals (CIs) 3.3–13; <i>p</i> &lt; 0.001). The magnitude of this association was larger and more precise than that yielded by person-level analyses (aOR = 2.9 [95% CI 1.2–7]), and substantially more precise than interspace-level, interspace-specific analyses which allowed the association between DHN and type II MC to vary across levels. Across exploratory analyses of disc signal intensity and other MC types, interspace-level, common-relationship analyses produced larger-magnitude and more precise associations than person-level analyses in most situations, and were more precise than interspace-level, interspace-specific analyses.</p> Conclusions <p>Interspace-level analytic approaches&#xa0;offer some advantages to person-level analyses that may be useful in understanding relationships between spinal degeneration findings.</p>

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A comparison of approaches to studying relationships between lumbar spinal degeneration findings demonstrates advantages to interspace-level analyses over person-level analyses

  • 期刊论文

  • 发表日期：

    2025年6月10日

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  • Pradeep Suri,
  • Elizaveta Elgaeva,
  • Jeffrey Jarvik,
  • Sean Rundell,
  • Yakov Tsepilov,
  • Frances Williams,
  • Patrick Heagerty

摘要

Purpose

To examine associations between lumbar intervertebral disc degeneration (LDD) and type II Modic changes (MC) when retaining information at each interspace (“interspace-level analysis”), as compared to aggregating information across interspaces as is typically done in spine research (“person-level analysis”). The study compared results from (1) interspace-level analyses assuming a common relationship across interspaces (the “interspace-level, common-relationship” approach), (2) interspace-level analyses allowing for interspace-specific associations (an “interspace-level, interspace-specific” approach), (3) and a conventional person-level analytic approach.

Methods

Adults in primary care (n = 147) received lumbar spine magnetic resonance imaging and neuroradiologist-evaluated assessments of prevalent disc height narrowing (DHN), type II MC, and other LDD parameters. Analyses examined associations between DHN and type II MC in interspace-level, common-relationship analyses, interspace-level, interspace-specific analyses, and conventional person-level analyses.

Results

Cross-sectional, interspace-level, common-relationship analyses found large-magnitude DHN-type II MC associations (adjusted OR [aOR] = 6.5, 95% confidence intervals (CIs) 3.3–13; p < 0.001). The magnitude of this association was larger and more precise than that yielded by person-level analyses (aOR = 2.9 [95% CI 1.2–7]), and substantially more precise than interspace-level, interspace-specific analyses which allowed the association between DHN and type II MC to vary across levels. Across exploratory analyses of disc signal intensity and other MC types, interspace-level, common-relationship analyses produced larger-magnitude and more precise associations than person-level analyses in most situations, and were more precise than interspace-level, interspace-specific analyses.

Conclusions

Interspace-level analytic approaches offer some advantages to person-level analyses that may be useful in understanding relationships between spinal degeneration findings.