Effects of age and sex on the distribution and symmetry of lumbar spinal and neural foraminal stenosis: a natural language processing analysis of 43,255 lumbar MRI reports.

Journal Article (Journal Article)

PURPOSE: The purpose of this study is to investigate relationship of patient age and sex to patterns of degenerative spinal stenosis on lumbar MRI (LMRI), rated as moderate or greater by a spine radiologist, using natural language processing (NLP) tools. METHODS: In this retrospective, IRB-approved study, LMRI reports acquired from 2007 to 2017 at a single institution were parsed with a rules-based natural language processing (NLP) algorithm for free-text descriptors of spinal canal stenosis (SCS) and neural foraminal stenosis (NFS) at each of six spinal levels (T12-S1) and categorized according to a 6-point grading scale. Demographic differences in the anatomic distribution of moderate (grade 3) or greater SCS and NFS were calculated by sex, and age and within-group differences for NFS symmetry (left vs. right) were calculated as odds ratios. RESULTS: Forty-three thousand two hundred fifty-five LMRI reports (34,947 unique patients, mean age = 54.7; sex = 54.9% women) interpreted by 152 radiologists were studied. Prevalence of significant SCS and NFS increased caudally from T12-L1 to L4-5 though less at L5-S1. NFS was asymmetrically more prevalent on the left at L2-L3 and L5-S1 (p < 0.001). SCS and NFS were more prevalent in men and SCS increased with age at all levels, but the effect size of age was largest at T12-L3. Younger patients (< 50 years) had relatively higher NFS prevalence at L5-S1. CONCLUSION: NLP can identify patterns of lumbar spine degeneration through analysis of a large corpus of radiologist interpretations. Demographic differences in stenosis prevalence shed light on the natural history and pathogenesis of LSDD.

Full Text

Duke Authors

Cited Authors

  • Travis Caton, M; Wiggins, WF; Pomerantz, SR; Andriole, KP

Published Date

  • June 2021

Published In

Volume / Issue

  • 63 / 6

Start / End Page

  • 959 - 966

PubMed ID

  • 33594502

Pubmed Central ID

  • PMC8128837

Electronic International Standard Serial Number (EISSN)

  • 1432-1920

Digital Object Identifier (DOI)

  • 10.1007/s00234-021-02670-6


  • eng

Conference Location

  • Germany