Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 10;18(1):12.
doi: 10.1186/s12891-016-1376-1.

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

Markus Hildebrandt  1 , Gabriela Fankhauser  2 , André Meichtry  3 , Hannu Luomajoki  4
Affiliations

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

Markus Hildebrandt et al. BMC Musculoskelet Disord. .

Abstract

Background: Lumbar multifidus muscles (LMM) are important for spinal motion and stability. Low back pain (LBP) is often associated with fat infiltration in LMM. An increasing fat infiltration of LMM may lead to lumbar dysfunction. The purpose of this study was to investigate whether there is a correlation between the severity of lumbar dysfunction and the severity of fat infiltration of LMM.

Methods: In a cross-sectional study, 42 patients with acute or chronic LBP were recruited. Their MRI findings were visually rated and graded using three criteria for fat accumulation in LMM: Grade 0 (0-10%), Grade 1 (10-50%) and Grade 2 (>50%). Lumbar sagittal range of motion, dynamic upright and seated posture control, sagittal movement control, body awareness and self-assessed functional disability were measured to determine the patients' low back dysfunction.

Results: The main result of this study was that increased severity of fat infiltration in the lumbar multifidus muscles correlated significantly with decreased range of motion of lumbar flexion (p = 0.032). No significant correlation was found between the severity of fat infiltration in LMM and impaired movement control, posture control, body awareness or self-assessed functional disability.

Conclusion: This is the first study investigating the relationship between the severity of fat infiltration in LMM and the severity of lumbar dysfunction. The results of this study will contribute to the understanding of the mechanisms leading to fat infiltration of LMM and its relation to spinal function. Further studies should investigate whether specific treatment strategies are effective in reducing or preventing fat infiltration of LMM.

Keywords: Fat infiltration; Flexibility; Low back pain; Multifidus muscle.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Sagittal view depicts the range (A-B) within axial MR images were analyzed
Fig. 2
Fig. 2
Grading of MR images with different muscle-fat compositions of lumbar multifidus muscle. The slice demonstrating the highest quantity of fat infiltration was graded accordingly
Fig. 3
Fig. 3
Measurement of upright Matthiass’ arm-raising test with the Spinal Mouse®. Segmental and total evasive movements for flexion or extension of the spine were calculated based on the difference between pre- and post-test posture
Fig. 4
Fig. 4
Boxplots showing the association between the severity of fat infiltration (Grade 0, 1 and 2) and lumbar flexion, movement control and posture control. Only decreased lumbar flexion correlated significantly with increased severity of fat infiltration in multifidus muscles. No significant association was found between the severity of fat infiltration and impaired movement control or impaired posture control
See this image and copyright information in PMC

References

    1. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15:192–300. doi: 10.1007/s00586-006-1072-1. - DOI - PMC - PubMed
    1. O’Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28:1074–9. - PubMed
    1. Luomajoki H, Kool J, de Bruin ED, Airaksinen O. Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord. 2008;9(1):170. doi: 10.1186/1471-2474-9-170. - DOI - PMC - PubMed
    1. Wand BM, Parkitny L, O’Connell NE, Luomajoki H, McAuley JH, Thacker M, et al. Cortical changes in chronic low back pain: current state of the art and implications for clinical practice. Man Ther. 2011;16(1):15–20. doi: 10.1016/j.math.2010.06.008. - DOI - PubMed
    1. Luomajoki H, Moseley GL. Tactile acuity and lumbopelvic motor control in patients with back pain and healthy controls. Br J Sports Med. 2011;45(5):437–40. doi: 10.1136/bjsm.2009.060731. - DOI - PubMed

LinkOut - more resources