| Popis: |
Study Design: Cross-sectional Objective: We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns. Summary of Background Data: Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulation patterns are inadequately described to optimise interventions. Methods: This cross-sectional study employed lumbar axial T1-weighted MRI in 107 Southern-Chinese adults (54 females, 53 males). Single-slices at the vertebral inferior end-plate per lumbar level were measured for quartiled-FI, and analysed against demographics, LBP, and disability (ODI: Oswestry Disability Index). Results: Mean FI% was higher in females, on the right, increased per level caudally, and from medial to lateral in men (p < 0.05). FI linearly increased with age for both sexes (p < 0.01) and was notably higher at L4&5 than L1,2&3 for cases aged 40-65yrs. BMI and FI were unrelated in females and inversely in males (p < 0.001). Females with LBPweek and males with LBPyear had 1.7% (each) less average FI (p < 0.05) than those without pain at that time-point. Men locating their LBP in the back had less FI than those without pain (p < 0.001). Disability was unrelated to FI for both sexes (p > 0.05). Conclusions: Lumbar paravertebral muscle FI predominates in the lower lumbar spine, notably for those aged 40-65, and depends more on sagittal than transverse distribution. Higher FI in females and differences of mean FI between sexes for BMI, LBP, and disabling ODI suggest sex-differential accumulation patterns. Our study contradicts pain models rationalising lumbar muscle FI and may reflect a normative sex-dependent feature of the natural history of lumbar paravertebral muscles. |
