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Title: Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults.
Epworth Authors: O'Sullivan, Richard
Other Authors: Teichtahl, Andrew
Urquhart, Donna
Wang, Yuanyuan
Wluka, Anita
Wijethilake, Pushpika
Cicuttini, Flavia
Keywords: Lumbar
Intervertebral Disc
Low Back Pain
Paraspinal Muscle
MRI Department, Healthcare Imaging Services, Epworth HealthCare, Victoria, Australia
Issue Date: Mar-2015
Publisher: Elsevier
Citation: Spine J. 2015 Jul 1;15(7):1593-601
Abstract: Low back pain and disability are major public health problems and may be related to paraspinal muscle abnormalities, such as a reduction in muscle size and muscle fat content. The aim of this study was to examine the associations between paraspinal muscle size and fat content with lumbar spine symptoms and structure. This was a community-based magnetic resonance imaging (MRI) cohort study. A total of 72 adults not selected on the basis of low back pain were included in the study. The outcomes measured were lumbar modic change and intervertebral disc height. Pain intensity and disability were measured from the Chronic Pain Grade Questionnaire at the time of MRI. The cross-sectional area (CSA) and amount of fat in multifidus and erector spinae (high percentage defined by >50% of muscle) were measured, and their association with outcome was assessed. Muscle CSA was not associated with low back pain/disability or structure. High percentage of fat in multifidus was associated with an increased risk of high-intensity pain/disability (odds ratio [OR], 12.6; 95% confidence interval [CI], 2.0–78.3; p=.007) and modic change (OR, 4.3; 95% CI, 1.1–17.3; p=.04). High fat replacement of erector spinae was associated with reduced intervertebral disc height (β=−0.9 mm; 95% CI, −1.4 to −0.3; p=.002) and modic change (OR, 4.9; 95% CI, 1.1–21.9; p=.04). Paraspinal fat infiltration, but not muscle CSA, was associated with high-intensity pain/disability and structural abnormalities in the lumbar spine. Although cause and effect cannot be determined from this cross-sectional study, longitudinal data will help to determine whether disabling low back pain and structural abnormalities of the spine are a cause or result of fat replacement of paraspinal muscles.
DOI: 10.1016/j.spinee.2015.03.039
PubMed URL:
ISSN: 1529-9430
Journal Title: The Spine Journal
Type: Journal Article
Affiliated Organisations: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Prahran, Victoria, Australia
Baker IDI Heart and Diabetes Institute, Prahran, Victoria, Australia
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Diagnostic Services
Pain Management

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