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Published on: August 8, 2019
Do Muscle Characteristics on Lumbar Spine Magnetic Resonance Imaging or Computed Tomography Predict Future Low Back
Pradeep Suri1, Adrielle L Fry2, Alfred C Gellhorn3
1Seattle Epidemiologic Research and Information Center (ERIC) Division of Rehabilitation Care Services, VA Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108; and Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA.
Few lumbar muscle characteristics on MRI/CT predict future low back pain (LBP) or physical performance. Most muscle features show no association with LBP outcomes, limiting their clinical predictive value.
Area of Science:
- Radiology
- Musculoskeletal Imaging
- Epidemiology
Background:
- Low back pain (LBP) is a prevalent condition with significant impact on function and performance.
- Identifying predictors of LBP course and physical limitations is crucial for effective clinical management.
- Lumbar muscle characteristics assessed via imaging may offer insights into LBP prognosis.
Purpose of the Study:
- To systematically review evidence on whether lumbar muscle characteristics on MRI/CT predict future LBP, functional limitations, or physical performance.
- To synthesize findings from observational cohort studies examining imaging-based muscle features as prognostic indicators.
Main Methods:
- Systematic review of PubMed, Embase, and CINAHL databases up to October 2014.
- Inclusion of 6 observational cohort studies assessing lumbar muscle characteristics on MRI/CT.
- Qualitative evidence synthesis due to study heterogeneity; bias assessment using Newcastle Ottawa Scale.
Main Results:
- Limited evidence suggests greater multifidus cross-sectional area predicts higher LBP intensity at 1 year.
- Limited evidence indicates erector spinae fat infiltration predicts LBP intensity and frequency at 15 years.
- Limited evidence shows CT-detected trunk muscle fat infiltration predicts worse physical performance in older adults.
Conclusions:
- Few lumbar muscle characteristics demonstrate limited evidence of association with future LBP or physical performance.
- The majority of examined muscle characteristics show limited evidence of no association with LBP outcomes.
- Current evidence suggests limited utility of most lumbar muscle imaging features for predicting future LBP or performance deficits.
