Automated radiomics pipeline integrating TotalSpineSeg for Pfirrmann grading of lumbar disc degeneration with SHAP-based interpretability

Background: Pfirrmann grading of lumbar disc degeneration (LDD) is constrained by inter-observer variability. Although radiomics enables objective quantification, the manual segmentation required by existing models is time-consuming and undermines feature reproducibility. TotalSpineSeg, an nnU-Net-based tool, allows fully automated segmentation, yet its integration with radiomics for Pfirrmann gra…