Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?
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BioMed Central
Open Access
Research article
Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? Per Kjaer*1, Tom Bendix1, Joan Solgaard Sorensen1, Lars Korsholm2 and Charlotte Leboeuf-Yde1 Address: 1The Back Research Center, Backcenter Funen, Part of Clinical Locomotion Science, University of Southern Denmark, Denmark and 2Department of biostatistics, University of Southern Denmark, Denmark Email: Per Kjaer* - [email protected]; Tom Bendix - [email protected]; Joan Solgaard Sorensen - [email protected] ; Lars Korsholm - [email protected]; Charlotte Leboeuf-Yde - [email protected] * Corresponding author
Published: 25 January 2007 BMC Medicine 2007, 5:2
doi:10.1186/1741-7015-5-2
Received: 1 June 2006 Accepted: 25 January 2007
This article is available from: http://www.biomedcentral.com/1741-7015/5/2 © 2007 Kjaer et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Because training of the lumbar muscles is a commonly recommended intervention in low back pain (LBP), it is important to clarify whether lumbar muscle atrophy is related to LBP. Fat infiltration seems to be a late stage of muscular degeneration, and can be measured in a noninvasive manner using magnetic resonance imaging. The purpose of this study was to investigate if fat infiltration in the lumbar multifidus muscles (LMM) is associated with LBP in adults and adolescents. Methods: In total, 412 adults (40-year-olds) and 442 adolescents (13-year-olds) from the general Danish population participated in this cross-sectional cohort study. People with LBP were identified through questionnaires. Using MRI, fat infiltration of the LMM was visually graded as none, slight or severe. Odds ratios were calculated for both age groups, taking into account sex, body composition and leisure time physical activity for both groups, and physical workload (in adults only) or daily bicycling (in adolescents only). Results: Fat infiltration was noted in 81% of the adults but only 14% of the adolescents. In the adults, severe fat infiltration was strongly associated with ever having had LBP (OR 9.2; 95% CI 2.0– 43.2), and with having LBP in the past year (OR 4.1; 1.5–11.2), but there was no such association in adolescents. None of the investigated moderating factors had an obvious effect on the OR in the adults. Conclusion: Fat infiltration in the LMM is strongly associated with LBP in adults only. However, it will be necessary to quantify these measurements objectively and to investigate the direction of this link longitudinally in order to determine if the abnormal muscle is the cause of LBP or vice versa.
Background It is generally believed that muscular insufficiency and low back pain (LBP) are linked, even though the main direction of this l
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