The Assessment of Paraspinal Muscle Epimuscular Fat in Participants with and Without Low Back Pain: A Case-Control Study

31 Pages Posted: 25 Jul 2023

See all articles by Brent Rosenstein

Brent Rosenstein

Concordia University

Jessica Burdick

Concordia University

Alexa Roussac

Concordia University

Meaghan Rye

Concordia University

Neda Naghdi

Concordia University

Stephanie Valentin

Edinburgh Napier University

Theresia Licka

University of Veterinary Medicine Vienna

Monica Sean

Université de Sherbrooke

Pascal Tétreault

Université de Sherbrooke

Jim Elliott

The University of Sydney

Maryse Fortin

Concordia University

Abstract

Measures obtained from conventional imaging of the lower back are poor predictors of low back pain (LBP) severity and future outcomes, but paraspinal muscle composition characteristics are seldomly explored. This project aimed to 1) compare epimuscular fat in participants with and without chronic LBP, and 2) determine whether epimuscular fat is associated with spinal levels, BMI, age, sex and LBP status, duration or severity. Fat and water lumbosacral MRIs of 50 chronic LBP participants and 41 healthy controls were used. The presence and extent of epimuscular fat for the paraspinal muscle group (erector spinae and multifidus) was assessed using a qualitative score (0-5 scale; 0=no epimuscular fat and 5=epimuscular fat present along the entire muscle) and quantitative manual segmentation method. Chi-squared tests evaluated associations between qualitative epimuscular fat ratings and LBP status at each lumbar level. Spearman’s rho correlation assessed relationships between quantitative and qualitative epimuscular fat with participants’ characteristics. Epimuscular fat was more frequent at the L4-L5 (X2= 13.781, p=0.017) and L5-S1 level (X2= 27.825, p<0.001) in participants with LBP compared to controls. The total qualitative score (combined from all levels) showed a significant positive correlation with BMI, age, sex (female) and LBP status (r=0.23-0.55; p<0.05). Similarly, the total area of epimuscular fat (quantitative measure) was significantly correlated with BMI, age and LBP status (r=0.26-0.57; p<0.05). No correlations were found between epimuscular fat and LBP duration or severity. Paraspinal muscle epimuscular fat is more common in chronic LBP patients. The functional implications of epimuscular fat should be further explored.

Note:
Funding Declaration: Support was received from The Quebec Bioimaging Network and the Austrian Science Fund (FWF) project P24020.

Conflicts of Interest: None

Ethical Approval: Ethics approval was obtained from the Central Ethics Committee of the Quebec Ministry of Health and Social Services (CCER-15-16-17), the Medical University of Vienna Ethics Committee (1609/2012) and by the institutional review board of the Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke (CIUSSS de l’Estrie – CHUS, 2021-3861). Written informed consent has been obtained from the patients to publish this paper.

Keywords: Low Back Pain, Magnetic Resonance Imaging, Paraspinal Muscles, Epimuscular Fat

Suggested Citation

Rosenstein, Brent and Burdick, Jessica and Roussac, Alexa and Rye, Meaghan and Naghdi, Neda and Valentin, Stephanie and Licka, Theresia and Sean, Monica and Tétreault, Pascal and Elliott, Jim and Fortin, Maryse, The Assessment of Paraspinal Muscle Epimuscular Fat in Participants with and Without Low Back Pain: A Case-Control Study. Available at SSRN: https://ssrn.com/abstract=4509292 or http://dx.doi.org/10.2139/ssrn.4509292

Brent Rosenstein

Concordia University ( email )

Canada

Jessica Burdick

Concordia University ( email )

Canada

Alexa Roussac

Concordia University ( email )

Canada

Meaghan Rye

Concordia University ( email )

Canada

Neda Naghdi

Concordia University ( email )

Canada

Stephanie Valentin

Edinburgh Napier University ( email )

Edinburgh, EH10 5LG
United States

Theresia Licka

University of Veterinary Medicine Vienna ( email )

Wien
Austria

Monica Sean

Université de Sherbrooke ( email )

Pascal Tétreault

Université de Sherbrooke ( email )

Jim Elliott

The University of Sydney ( email )

University of Sydney
Sydney, 2006
Australia

Maryse Fortin (Contact Author)

Concordia University ( email )

Canada

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