LIVS Dictionary: reference values for lumbar reference values for lumbar intervertebral spacing in a Chinese...

Area of Science:

• Radiology and Imaging
• Anatomy
• Spine Biomechanics

Background:

• Lumbar intervertebral space (LIVS) alterations can result from spinal injuries.
• A standardized reference system is needed to accurately assess LIVS morphology and detect injuries.
• Existing methods lack comprehensive, sex-specific normative data for LIVS.

Purpose of the Study:

• To establish the first computed tomography (CT)-based Lumbar Intervertebral Space (LIVS) Dictionary.
• To define sex-specific normative data for LIVS parameters.
• To evaluate the LIVS Dictionary's efficacy in detecting ligamentous injuries.

Main Methods:

• Retrospective analysis of whole-abdominal CT scans from 457 asymptomatic adults.
• Quantification of 28 LIVS parameters across seven anatomical regions using 3D Slicer.
• Validation using a cohort of 87 patients with lumbar fractures and advanced statistical analysis including Elastic Net ROC curve.

Main Results:

• Significant sex-specific differences in LIVS parameters were observed, with males generally having larger spaces.
• Age-related degeneration patterns differed between sexes, with males showing progressive reduction and females exhibiting localized decline after 80.
• The Elastic Net model achieved high diagnostic performance (AUC=0.90, accuracy=0.94) in detecting injuries, particularly transverse process fractures.

Conclusions:

• Lumbar spine injuries cause measurable changes in LIVS morphology.
• The LIVS Dictionary offers a validated framework for identifying these changes, accounting for sex, age, and fracture type.
• This system supports clinical evaluation, biomechanical modeling, and forensic analysis of spinal stability.