The assessment of paraspinal muscle epimuscular fat in participants with and without low back pain: A case-control study

It remains unclear whether paraspinal muscle fatty infiltration in low back pain (LBP) is i) solely intramuscular, ii) is lying outside the epimysium between the muscle and fascial plane (epimuscular) or iii) or combination of both, as imaging studies often use different segmentation protocols that...

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Bibliographic Details
Published in:Journal of biomechanics 2024-01, Vol.163, p.111928-111928, Article 111928
Main Authors: Rosenstein, Brent, Burdick, Jessica, Roussac, Alexa, Rye, Meaghan, Naghdi, Neda, Valentin, Stephanie, Licka, Theresia, Sean, Monica, Tétreault, Pascal, Elliott, Jim, Fortin, Maryse
Format: Article
Language:English
Subjects:
Age
Back pain
Back surgery
Bivariate analysis
Body mass index
Case-Control Studies
Correlation
Epimuscular fat
Ethics
Female
Health care
Humans
Image segmentation
Low back pain
Low Back Pain - physiopathology
Lumbar Vertebrae - physiopathology
Lumbosacral Region
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Methods
Muscle contraction
Muscles
Pain
Paraspinal muscles
Paraspinal Muscles - diagnostic imaging
Qualitative analysis
Segmentation
Sex
Spine - physiopathology
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Summary:It remains unclear whether paraspinal muscle fatty infiltration in low back pain (LBP) is i) solely intramuscular, ii) is lying outside the epimysium between the muscle and fascial plane (epimuscular) or iii) or combination of both, as imaging studies often use different segmentation protocols that are not thoroughly described. Epimuscular fat possibly disturbs force generation of paraspinal muscles, but is seldomly explored. This project aimed to 1) compare epimuscular fat in participants with and without chronic LBP, and 2) determine whether epimuscular fat is different across lumbar spinal levels and associated with BMI, age, sex and LBP status, duration or intensity. Fat and water lumbosacral MRIs of 50 chronic LBP participants and 41 healthy controls were used. The presence and extent of epimuscular fat for the paraspinal muscle group (erector spinae and multifidus) was assessed using a qualitative score (0–5 scale; 0 = no epimuscular fat and 5 = epimuscular fat present along the entire muscle) and quantitative manual segmentation method. Chi-squared tests evaluated associations between qualitative epimuscular fat ratings and LBP status at each lumbar level. Bivariate and partial spearman’s rho correlation assessed relationships between quantitative and qualitative epimuscular fat with participants’ characteristics. Epimuscular fat was more frequent at the L4-L5 (X2 = 13.781, p = 0.017) and L5-S1 level (X2 = 27.825, p 
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2024.111928