Search

Purpose: Changes in the cross-sectional area (CSA) and functional cross-sectional area (FCSA) of the lumbar multifidus (MF) and erector spinae muscles (ES) are factors that can contribute to low back pain. For the assessment of muscle CSA and composition there are various software and threshold methods used for tissue segmentation in quantitative analysis. However, there is currently no gold standard for software as well as muscle segmentation. This study aims to analyze the measurement error between different image processing software and different threshold methods for muscle segmentation. Methods: Magnetic resonance images (MRI) of 60 patients were evaluated. Muscle CSA and FCSA measurements were acquired from axial T2-weighted MRI of the MF and ES at L4/L5 and L5/S1. CSA, FCSA, and FCSA/CSA ratio were measured independently by two observers. The MRI images were measured using two different software programs (ImageJ and Amira) and with two threshold methods (Circle/Overlap method) for each software to evaluate FCSA and FCSA/CSA ratio. Results: Inter-software comparisons revealed high inter-rater reliability. However, poor inter-rater reliability were obtained with different threshold methods. CSA, FCSA, and FCSA/CSA showed excellent inter-software agreement of 0.75–0.99 regardless of the threshold segmentation method. The inter-rater reliability between the two observers ranged between 0.75 and 0.99. Comparison of the two segmentation methods revealed agreement between 0.19 and 0.84. FCSA and FCSA/CSA measured via the Overlap method were significantly higher than those measured via the Circle method (P < 0.01). Conclusion: The present study showed a high degree of reliability with very good agreement between the two software programs. However, study results based on different threshold methods should not be directly compared. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.QuestionWhat is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life?FindingscLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration.Clinical relevanceUnderstanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.Methods: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.QuestionWhat is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life?FindingscLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration.Clinical relevanceUnderstanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.Results: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.QuestionWhat is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life?FindingscLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration.Clinical relevanceUnderstanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.Conclusion: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.QuestionWhat is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life?FindingscLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration.Clinical relevanceUnderstanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.Key Points: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.QuestionWhat is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life?FindingscLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration.Clinical relevanceUnderstanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life.Graphical Abstract: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging. Cross-sectional area (CSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured. Data were analyzed using multiple linear and binary logistic regression.Compared to the cLBP group, the no-BP group had smaller CSA influenced by FI of ES at L5/S1 (p = 0.01), higher FCSA of ES (p < 0.01) at L4/L5, and lower FI of ES and MF at L4/L5 and L5/S1 (p < 0.01). CSA, FCSA, and FI showed no significant correlation with cLBP intensity except for the CSA (p = 0.02) and FCSA (p = 0.03) of the L2/3 MF. Pain duration positively correlated with FI at L2/3, L3/4, and L4/5 of MF and ES (p < 0.05) and CSA of the L1/2 MF (p = 0.02). CSA (L3/4, L4/5, and L5/S1) and FCSA (L4/5, L5/S1) of MF correlated positively with SF36 scores (p < 0.05), while ES muscles did not (p > 0.05). FI of MF and ES showed no correlation with SF36 scores.CSA and FI were significantly higher, and FCSA significantly lower in paraspinal muscles of cLBP patients compared to asymptomatic participants. Increased FI correlated with prolonged cLBP duration, indicating FI and FCSA alterations may play a significant role in cLBP development and duration.QuestionWhat is the relationship between paraspinal muscle quality and cLBP, including its intensity, duration, and impact on quality of life?FindingscLBP patients had increased FI and reduced functional muscle area in paraspinal muscles, with FI correlating with prolonged pain duration.Clinical relevanceUnderstanding the changes in lumbar paraspinal muscles provides insight into cLBP progression, guiding personalized interventions to improve pain management and patient quality of life. [ABSTRACT FROM AUTHOR]