Vertebral bone quality score was associated with paraspinal muscles fat infiltration, but not modic classification in patients with chronic low back pain: a prospective cross-sectional study

• Published in: BMC musculoskeletal disorders 2024-07, Vol.25 (1), p.509-8, Article 509
• Main Authors: Chen, Jiaxin, Huang, Yilong, Yang, Yingjuan, Wang, Zhongwei, Zhao, Derong, Luo, Mingbin, Pu, Fushun, Yang, Juntao, Zhang, Zhenguang, He, Bo
• Format: Article
• Language: English
• Subjects: Abdomen; Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Adult; Age; Aged; Back pain; Backache; Body mass index; Bodybuilders; Bone density; Bone marrow; Chronic illnesses; Chronic low back pain; Chronic pain; Chronic Pain - diagnostic imaging; Classification; Correlation analysis; Cross-Sectional Studies; Development and progression; Fat infiltration; Female; Gender; Health facilities; Humans; Low back pain; Low Back Pain - diagnostic imaging; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Magnetic Resonance Imaging; Male; Medical research; Medicine, Experimental; Middle Aged; Modic changes; Muscles; Neuromuscular diseases; Normal distribution; Paraspinal muscles; Paraspinal Muscles - diagnostic imaging; Paraspinal Muscles - pathology; Patients; Physiological aspects; Prospective Studies; Regression analysis; Reproducibility; Risk factors; Spine (lumbar); Statistical analysis; Tomography; Vertebrae; Vertebral bone quality score
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07626-4

The lumbar vertebra and paraspinal muscles play an important role in maintaining the stability of the lumbar spine. Therefore, the aim of this study was to investigate the relationship between paraspinal muscles fat infiltration and vertebral body related changes [vertebral bone quality (VBQ) score and Modic changes (MCs)] in patients with chronic low back pain (CLBP). Patients with CLBP were prospectively collected in four hospitals and all patients underwent 3.0T magnetic resonance scanning. Basic clinical information was collected, including age, sex, course of disease (COD), and body mass index (BMI). MCs were divided into 3 types based on their signal intensity on T1 and T2-weighted imaging. VBQ was obtained by midsagittal T1-weighted imaging (T1WI) and calculated using the formula: SI /SI . The Proton density fat fraction (PDFF) values and cross-sectional area (CSA) of paraspinal muscles were measured on the fat fraction map from the iterative decomposition of water and fat with the echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) sequences and in/out phase images at the central level of the L4/5 and L5/S1 discs. This study included 476 patients with CLBP, including 189 males and 287 females. 69% had no Modic changes and 31% had Modic changes. There was no difference in CSA and PDFF for multifidus(MF) and erector spinae (ES) at both levels between Modic type I and type II, all P values>0.05. Spearman correlation analysis showed that VBQ was weakly negatively correlated with paraspinal muscles CSA (all r values