Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain

Hildebrandt, Michelle A.T.; Fankhauser, Grant T.; Meichtry, André; Luomajoki, Hannu

doi:10.1016/j.physio.2015.03.3379

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…Most studies used the center of the intervertebral disc 10,21,[27][28][29][30]39,43,45,50,52,53,56,[59][60][61][62]65,71,74,79 or the superior/inferior endplate 9,15,19,20,26,31,34,35,41,44,[47][48][49]57,63,64,66,[68][69][70]82,83,85 as the level of slice. These slices are common and available in clinical practice.…”

Section: Slice Selectionmentioning

confidence: 99%

“…Visual Semiquantitative Parameters Our review showed that several early studies used semiquantitative visual grading with distinct cut-off points (2-point scale 19,67 , 19,67 , 3-point scale 9,16,49,64,68,78 , 4-point scale 7,15,18,29,34,37,48,50,59,80 , and 5-point scale 17,28,35,51 ). When muscles were graded, the interobserver and intraobserver agreements were both acceptable with or without cut-off points 7,34,51 .…”

Section: Imaging Parametersmentioning

confidence: 99%

“…Semiquantitative evaluation is convenient and intuitive in clinical practice. Studies have reported that higher FI of paraspinal muscles based on semiquantitative evaluation was correlated to functional disability, pain level, and decreased range of motion of lumbar flexion in LBP patients 9,49,64,68 . Teichtahl et al also reported that paraspinal FI, but not muscle area, was associated with highintensity pain, disability, and structural abnormalities in community-based adults 50 .…”

Section: Imaging Parametersmentioning

confidence: 99%

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Imaging Evaluation of Fat Infiltration in Paraspinal Muscles on MRI: A Systematic Review with a Focus on Methodology

Han

Jiang

Zhang

et al. 2021

Orthopaedic Surgery

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Purpose: Numerous studies have applied a variety of methods to assess paraspinal muscle degeneration. However, the methodological differences in imaging evaluation may lead to imprecise or inconsistent results. This article aimed to provide a pragmatic summary review of the current imaging modalities, measurement protocols, and imaging parameters in the evaluation of paraspinal muscle fat infiltration (FI) in MRI studies.Methods: Web of Science, EMBASE, and PubMed were searched from January 2005 to March 2020 to identify studies that examined the FI of paraspinal muscles on MRI among patients with lumbar degenerative diseases.Results: Intramyocellular lipids measured by magnetic resonance spectroscopy and FI measured by chemical-shift MRI were both correlated to low back pain and several degenerative lumbar diseases, whereas results on the relationship between FI and degenerative lumbar pathologies using conventional MRI were conflicting. Multi-segment measurement of FI at the lesion segment and adjacent segments could be a prognostic indicator for lumbar surgery. Most studies adopted the center of the intervertebral disc or endplate as the level of slice to evaluate the FI. Compared with visual semiquantitative assessment, quantitative parameters appeared to be precise for eliminating individual or modality differences. It has been demonstrated that fat CSA/total CSA (based on area) and muscle-fat index (based on signal intensity) as quantitative FI parameters are associated with multiple lumbar diseases and clinical outcomes after surgery. Conclusion:Having a good command of the methodology of paraspinal muscle FI on MRI was effective for diagnosis and prognosis in clinical practice.

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Section: Slice Selectionmentioning

confidence: 99%

Section: Imaging Parametersmentioning

confidence: 99%

Section: Imaging Parametersmentioning

confidence: 99%

See 1 more Smart Citation

Imaging Evaluation of Fat Infiltration in Paraspinal Muscles on MRI: A Systematic Review with a Focus on Methodology

Han

Jiang

Zhang

et al. 2021

Orthopaedic Surgery

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“…Apart from enhanced efficiency, automated methods also facilitate observer-independent processing. 8 The fat-fraction of muscle tissue is not only relevant for the assessment of neuromuscular diseases, but is also utilized for investigations of other diseases such as lower back pain 9,10 as well as traumatic neck pain. 11,12 Approaches for segmentation so far make use of unsupervised techniques, such as active contours, 13 clustering, 14,15 random walks, 16,17 or atlas approaches.…”

mentioning

confidence: 99%

Domain‐specific data augmentation for segmenting MR images of fatty infiltrated human thighs with neural networks

Gadermayr

Müller

et al. 2019

Magnetic Resonance Imaging

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Background Fat‐fraction has been established as a relevant marker for the assessment and diagnosis of neuromuscular diseases. For computing this metric, segmentation of muscle tissue in MR images is a first crucial step. Purpose To tackle the high degree of variability in combination with the high annotation effort for training supervised segmentation models (such as fully convolutional neural networks). Study Type Prospective. Subjects In all, 41 patients consisting of 20 patients showing fatty infiltration and 21 healthy subjects. Field Strength/Sequence: The T1‐weighted MR‐pulse sequences were acquired on a 1.5T scanner. Assessment To increase performance with limited training data, we propose a domain‐specific technique for simulating fatty infiltrations (i.e., texture augmentation) in nonaffected subjects' MR images in combination with shape augmentation. For simulating the fatty infiltrations, we make use of an architecture comprising several competing networks (generative adversarial networks) that facilitate a realistic artificial conversion between healthy and infiltrated MR images. Finally, we assess the segmentation accuracy (Dice similarity coefficient). Statistical Tests A Wilcoxon signed rank test was performed to assess whether differences in segmentation accuracy are significant. Results The mean Dice similarity coefficients significantly increase from 0.84–0.88 (P < 0.01) using data augmentation if training is performed with mixed data and from 0.59–0.87 (P < 0.001) if training is conducted with healthy subjects only. Data Conclusion Domain‐specific data adaptation is highly suitable for facilitating neural network‐based segmentation of thighs with feasible manual effort for creating training data. The results even suggest an approach completely bypassing manual annotations. Level of Evidence: 4 Technical Efficacy: Stage 3

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“…Fat infiltration of the multifidus muscle on MRI was graded as "grade 0" for 0-10% fat, "grade 1" for 10-50% fat, and "grade 2" for > 50% fat (Fig. 1) [9]. Apart from these studies, there are studies evaluating muscle cross-sectional areas [10,11].…”

mentioning

confidence: 99%

Magnetic resonance imaging changes in multifidus and psoas muscles in patients with lumbar spinal stenosis

Çavuş

2021

The European Research Journal

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Objectives:The aim of this study is to evaluate the relationship between the spinal canal cross-sectional area (SCCSA) at the stenosis level, the cross-sectional areas of the multifidus (MF) muscle at the L3-S1 levels, and the cross-sectional areas of the psoas muscle (PSCSA) at the L3 level in patients with nerve compression due to lumbar spinal stenosis. Methods: A total of 280 patients were included in the study, 140 in the control group and 140 with lumbar spinal stenosis that had been detected with magnetic resonance imaging (MRI). The patients' ages, gender, SCCSA at the level of stenosis, PSCSA at L3 level, MFCSA at L3-S1 levels, and degrees of atrophy caused by multifidus muscle fatty degeneration were evaluated and compared with the control group whether the comparison was statistically significant or not. Results: PSCSA values at the L3 level and MFCSA at the L3-4 level (r = 0.555, p < 0.01), MFCSA at the L4-L5 level (r = 0.559, p < 0.01), and MFCSA at the L5-S1 level (r = 0.429, p < 0.01) were found to have a statistically significant positive correlation. In addition, MFCSA at the L3-4 level (p < 0.001), MFCSA at the L4-5 level (p < 0.001), MFCSA at the L5-S1 level (p < 0.001),the L3-L4 SCCSA (p < 0.001), and the L4-L5 SCCSA (p < 0.001) mean values were found to be statistically significantly lower than the mean of the cases in the control group. Conclusions: Compared to the control group, a significant correlation was found with a decrease in the CSA of the multifidus muscle and the presence of fatty degeneration of the multifidus muscle in patients with spinal stenosis. However, in the CSA of the psoas muscle at the L3 level, it was found that there was no correlation between patients with spinal stenosis and the control group.

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Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain

Cited by 5 publications

References 11 publications

Imaging Evaluation of Fat Infiltration in Paraspinal Muscles on MRI: A Systematic Review with a Focus on Methodology

Imaging Evaluation of Fat Infiltration in Paraspinal Muscles on MRI: A Systematic Review with a Focus on Methodology

Domain‐specific data augmentation for segmenting MR images of fatty infiltrated human thighs with neural networks

Magnetic resonance imaging changes in multifidus and psoas muscles in patients with lumbar spinal stenosis

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