Multifidus Fat Infiltration in Patients with Persistent Spinal Pain Syndrome Type II Treated with Spinal Cord...

Area of Science:

• Spinal Surgery
• Pain Management
• Medical Imaging

Background:

• Multifidus muscle dysfunction is linked to chronic postsurgical pain.
• Previous research indicates lumbar multifidus structural impairments in chronic low back pain patients.
• This study investigates multifidus fat infiltration post-Spinal Cord Stimulation (SCS).

Purpose of the Study:

• To determine the prevalence of multifidus fat infiltration in patients treated with SCS.
• To assess the inter-rater reliability of MRI-based fat infiltration evaluation.
• To explore the feasibility of manual segmentation for multifidus muscle volume assessment.

Main Methods:

• Retrospective analysis of MRI data from four Persistent Spinal Pain Syndrome Type II (PSPS II) patients treated with SCS.
• Manual segmentation of multifidus muscles by two independent operators on lumbar spine MRI.
• Quantification of fat-to-muscle ratio and classification of fat infiltration severity.
• Calculation of inter-rater reliability for muscle volume measurements.

Main Results:

• All patients exhibited moderate-to-severe multifidus fat infiltration across all lumbar spinal levels.
• Median fat-to-muscle ratios ranged from 46.12% (L2-L3) to 52.84% (L5-S1).
• Excellent inter-rater reliability (ICC=1) was achieved for multifidus muscle volume assessment.

Conclusions:

• Moderate-to-severe multifidus fat infiltration is prevalent in SCS-treated patients.
• Manual MRI segmentation for multifidus muscle volume is reliable but time-intensive.
• Future research should prioritize automated segmentation and classification methods for efficiency.