PT  - JOURNAL ARTICLE
AU  - Enrico Giordan
AU  - Giacomo Drago
AU  - Roberto Zanata
AU  - Elisabetta Marton
AU  - Jacopo Del Verme
TI  - The Correlation Between Paraspinal Muscular Morphology, Spinopelvic Parameters, and Back Pain: A Comparative Cohort Study
AID  - 10.14444/8531
DP  - 2023 Oct 01
TA  - International Journal of Spine Surgery
PG  - 627--637
VI  - 17
IP  - 5
4099  - http://ijssurgery.com//content/17/5/627.short
4100  - http://ijssurgery.com//content/17/5/627.full
SO  - Int J Spine Surg2023 Oct 01; 17
AB  - Background The relationship between paraspinal muscle degeneration and low back pain (LBP), disability, and structural changes has been investigated in the literature, but it is still a matter of debate. We differentiated paraspinal muscle magnetic resonance imaging by quality and quantity, focusing on fatty infiltration (FI) and paraspinal muscles cross-sectional area (CSA) from T12 to S1 in patients with and without chronic LBP. We aimed to determine whether paraspinal muscle quantity (CSA) and quality (FI) are positively associated with LBP or degenerative/spinopelvic changes in the spine.Methods Between 2018 and 2021, we prospectively enrolled 205 patients aged between 18 to 65 years, of whom 153 patients had chronic back pain (back pain group) and 52 patients did not have chronic back pain (no back pain group), and collected clinicodemographic, structural, and spinopelvic data. We correlated these data with paraspinal muscle FI and CSA from T12 to S1. Multivariate models were run to highlight associations between pain, disability, or degenerative and spinopelvic parameters.Results Age was not associated with increased FI but consistently with decreased CSA values. After adjusting for age, sex, and body mass index, FI was associated with an increased risk of back pain (OR, 8.80; 95% CI, 1.9–39.79; P = 0.006) and high disability scores (OR, 3.41; 95% CI, 1.12–10.30; P = 0.030). Decreased CSA was associated with reduced disc height (P < 0.001), while FI and CSA did not associate with abnormal spinopelvic parameters.Conclusions FI on paraspinal muscle highly correlates with back pain and disability but was not found in structural and degenerative changes in the lower back.Clinical Relevance Findings from this study are clinically relevant for patient counseling and rehabilitation strategies.Level of Evidence 2b.