Cervical Subcutaneous Fat Index and Lordosis in Intervertebral Disc Degeneration: Is There a Link?

Objective : This retrospective study aimed to investigate the relationship between cervical intervertebral disc degeneration (IVDD), cervical lordosis angle (CL), and the posterior Subcutaneous Fat Index (SFI) in adults presenting with neck pain. Methods : A total of 250 patients aged 18–65 years who underwent cervical MRI between 2023 and 2025 were evaluated. Intervertebral discs from C2–T1 were graded using the Pfirrmann classification on T2-weighted midsagittal images. The CL was measured by the posterior tangent method from C2–C7. Posterior SFI was calculated as the ratio of subcutaneous fat thickness to total posterior soft tissue thickness (fat + muscle). Patients were classified into loss of lordosis and normal lordosis groups. Independent samples t-test, Spearman’s correlation, and multiple regression analyses were applied. Results : The mean age of the cohort was 39.15±12.79 years, with 58% females and 42% males. The mean BMI was 22.45±1.48 kg/m² and the mean CL angle was −10.08±11.33°. No significant differences in segmental SFI values were observed between loss of lordosis (n=96) and normal lordosis (n=154) groups (all p>0.05). Pfirrmann grades were also similar across most levels, except for C6–7, where significantly greater degeneration was detected in the normal lordosis group (p=0.039). No significant correlations were found between CL and either SFI or Pfirrmann grades. In regression analysis, age, BMI, SFI, and Pfirrmann grade were not independent predictors of CL. Conclusion : Posterior cervical SFI and lordosis angle were not generally associated with IVDD in this cohort. The significant finding at the C6–7 level should be considered an isolated result. These data support the multifactorial nature of IVDD and highlight the need for larger, prospective studies.