• Vahid Abdollah, Eric C Parent, Samin Dolatabadi, Erica Marr, Keith Wachowicz, and Michele Battié.
• Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G2G4, Canada.
• Eur Spine J. 2022 Aug 1; 31 (8): 1979-1991.

BackgroundRecent advances in texture analysis and machine learning offer new opportunities to improve the application of imaging to intervertebral disc biomechanics. This study employed texture analysis and machine learning on MRIs to investigate the lumbar disc's response to loading.MethodsThirty-five volunteers (30 (SD 11) yrs.) with and without chronic back pain spent 20 min lying in a relaxed unloaded supine position, followed by 20 min loaded in compression, and then 20 min with traction applied. T2-weighted MR images were acquired during the last 5 min of each loading condition. Custom image analysis software was used to segment discs from adjacent tissues semi-automatically and segment each disc into the nucleus, anterior and posterior annulus automatically. A grey-level, co-occurrence matrix with one to four pixels offset in four directions (0°, 45°, 90° and 135°) was then constructed (320 feature/tissue). The Random Forest Algorithm was used to select the most promising classifiers. Linear mixed-effect models and Cohen's d compared loading conditions.FindingsAll statistically significant differences (p < 0.001) were observed in the nucleus and posterior annulus in the 135° offset direction at the L4-5 level between lumbar compression and traction. Correlation (P2-Offset, P4-Offset) and information measure of correlation 1 (P3-Offset, P4-Offset) detected significant changes in the nucleus. Statistically significant changes were also observed for homogeneity (P2-Offset, P3-Offset), contrast (P2-Offset), and difference variance (P4-Offset) of the posterior annulus.InterpretationMRI textural features may have the potential of identifying the disc's response to loading, particularly in the nucleus and posterior annulus, which appear most sensitive to loading.Level Of EvidenceDiagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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