Introduction. Low back pain and disc degeneration could be linked to global spinal geometry. Our study aimed to develop a reliable new mathematical method to assess the local distribution of total lumbar lordosis with a single numeric parameter and compare it with lumbar intervertebral disc degeneration using routine MRI scans. Methods. An online, open access, easy-to-use platform for measurements was developed based on a novel mathematical approach using MRIs of 60 patients. Our Spinalyze Software can be used online with uploaded MRIs. Several new parameters were introduced and assessed to describe variation in segmental lordosis distribution with a single numerical value. The Pfirrmann grading system was used for the classification of lumbar intervertebral disc degeneration. Relationships were investigated between the grade categories of L1-S1 lumbar discs and the MRI morphological parameters with correlation analysis. Results. Results confirm that the determination of measurement points and calculated parameters are reliable (ICCs and Pearson r values > 0.90), and these parameters were independent of gender. The digression percentage (K%), one of our new parameters, did not show a statistical relationship with the Cobb-angle. According to our results, the maximum deflection breaking-point of lumbar lordosis and its location can be different with the same Cobb-angle and the distribution of global lordosis is uneven because the shape of the lumbar lordosis is shifted downward and centered around the L4 lumbar vertebra. The interobserver reliability of the Pfirrmann grades reading was in the excellent agreement category (88.33% agreement percentage, 0.84 kappa), and digression percentage (K%) showed a significant negative correlation with all L1-S1 disc grades with increasing r correlation values. This means that the smaller the value of digression percentage (K%), the more the number of worn discs in the lower lumbar sections. Conclusions. Spinalyze Software based on a novel mathematical approach provides a free, easy-to-use, reliable, and online measurement tool using standard MRIs to approximate the curvature of lumbar lordosis. The new reliable K% (digression percentage) is one single quantitative parameter to assess the local distribution of total lumbar lordosis. The results indicate that digression percentage (K%) may possibly be associated with the development of lumbar intervertebral disc degeneration. Further evaluation is needed to assess its behavior and advantage.

中文翻译：

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用新的数学方法评估腰椎前凸分布及其对腰椎间盘退变的适应。

简介。腰痛和椎间盘退变可能与整体脊柱几何形状有关。我们的研究旨在开发一种可靠的新数学方法，以使用单个数值参数评估总腰椎前凸的局部分布，并将其与使用常规 MRI 扫描的腰椎间盘退变进行比较。方法. 基于一种新的数学方法，使用 60 名患者的 MRI，开发了一个在线、开放访问、易于使用的测量平台。我们的 Spinalyze 软件可与上传的 MRI 一起在线使用。引入并评估了几个新参数，以用单个数值描述节段性脊柱前凸分布的变化。Pfirrmann分级系统用于腰椎间盘退变的分类。采用相关性分析研究L1-S1腰椎间盘分级与MRI形态学参数之间的关系。结果。结果证实测量点的确定和计算的参数是可靠的（ICCs 和 Pearson r值 > 0.90），并且这些参数与性别无关。我们的新参数之一离题百分比 ( K %) 没有显示出与 Cobb 角的统计关系。根据我们的结果，相同的 Cobb 角下，腰椎前凸的最大偏转折点及其位置可能不同，并且由于腰椎前凸的形状向下移动并以 L4 腰椎为中心，整体前凸的分布不均匀椎骨。Pfirrmann 等级读数的观察者间信度属于优秀一致性类别（88.33% 一致性百分比，0.84 kappa），离题百分比（K %）与所有 L1-S1 椎间盘等级呈显着负相关，随着r的增加相关值。这意味着离题百分比 ( K %) 的值越小，腰椎下段磨损的椎间盘数越多。结论。Spinalyze 软件基于一种新颖的数学方法，提供了一种免费、易于使用、可靠的在线测量工具，使用标准 MRI 来近似腰椎前凸曲率。新的可靠K %（离题百分比）是评估总腰椎前凸的局部分布的单一定量参数。结果表明，离题百分比（K %）可能与腰椎间盘退变的发展有关。需要进一步评估以评估其行为和优势。