Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults

被引：271

作者：

Teichtahl, Andrew J. ^{[1
,2
]}

Urquhart, Donna M. ^{[1
]}

Wang, Yuanyuan ^{[1
]}

Wluka, Anita ^{[1
]}

Wijethilake, Pushpika ^{[1
]}

O'Sullivan, Richard ^{[3
,4
]}

Cicuttini, Flavia M. ^{[1
]}

机构：

[1] Monash Univ, Alfred Hosp, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia

[2] Baker IDI Heart & Diabet Inst, Prahran, Vic 3004, Australia

[3] Epworth Med Fdn, MRI Dept, Healthcare Imaging Serv, Richmond, Vic 3121, Australia

[4] Monash Univ, Cent Clin Sch, Dept Med, Prahran, Vic 3004, Australia

来源：

SPINE JOURNAL | 2015年 / 15卷 / 07期

基金：

澳大利亚国家健康与医学研究理事会;

关键词：

Lumbar; Intervertebral disc; Modic; Muscle; Fat; Low back pain; Disability; DEGENERATIVE DISK DISEASE; HEALTHY CONTROL SUBJECTS; VERTEBRAL END-PLATES; MARROW CHANGES; MODIC CHANGES; LUMBAR SPINE; ASYMPTOMATIC VOLUNTEERS; MULTIFIDUS MUSCLES; MR SPECTROSCOPY; TYPE-2; CHANGES;

D O I：

10.1016/j.spinee.2015.03.039

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

BACKGROUND CONTEXT: 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. PURPOSE: The aim of this study was to examine the associations between paraspinal muscle size and fat content with lumbar spine symptoms and structure. STUDY DESIGN/SETTING: This was a community-based magnetic resonance imaging (MRI) cohort study. PATIENT SAMPLE: A total of 72 adults not selected on the basis of low back pain were included in the study. OUTCOME MEASURES: 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. METHODS: 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. RESULTS: 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 (beta=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). CONCLUSIONS: Paraspinal fat infiltration, but not muscle CSA, was associated with highintensity 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. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：1593 / 1601

页数：9

共 42 条

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