ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
MRI-based radiomics reveals disc-level radiomic heterogeneity and is associated with symptom severity in single-level lumbar disc herniation.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo characterize adjacent-level disc radiomic differences and symptom associations in single-level lumbar disc herniation (LDH) on sagittal T2-weighted MRI.
methodsThis retrospective single-center study included 100 patients with MRI-confirmed single-level LDH. The index herniated disc (Label 1) and cranial adjacent disc (Label 2) were segmented in all patients; the caudal adjacent disc (Label 3) was analyzed when anatomically present and a complete radiomics record was available (n = 68). A total of 107 original PyRadiomics features were extracted per ROI. Paired Wilcoxon signed-rank tests with Benjamini-Hochberg false discovery rate correction were used for Label 1 vs. Label 2, Label 1 vs. Label 3, and Label 2 vs. Label 3. Sensitivity analyses excluded shape features, repeated Label 1 vs. Label 2 in complete three-level cases, stratified by index level, and compared index with non-index discs at the same anatomical level. Symptom associations were assessed using Spearman and partial Spearman analyses.
resultsPfirrmann grades differed across available levels in complete three-level cases (median [IQR]: 3 [2-3], 2 [2-2], and 2 [2-3] for Labels 1-3; Friedman p < 0.0001). Radiomics identified 71, 86, and 47 significant features for the three paired comparisons, respectively. Substantial non-shape differences remained after excluding shape features (59/93, 75/93, and 34/93 significant features). A non-shape summary score (PC1) at the index level was associated with VAS (rho = 0.49) and ODI (rho = 0.41), with similar adjusted results.
conclusionMRI-based radiomics provides complementary quantitative disc phenotyping in single-level LDH, revealing robust adjacent-level differences and moderate cross-sectional symptom associations. Longitudinal evaluation and external validation are required before prognostic use.
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