Spinal degeneration is associated with lumbar multifidus morphology in secondary care patients with low back or leg pain

• Published in: Scientific reports Vol. 12; no. 1; p. 14676
• Main Authors: Cooley, Jeffrey R., Jensen, Tue S., Kjaer, Per, Jacques, Angela, Theroux, Jean, Hebert, Jeffrey J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.08.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/174; 692/4023/1671; 692/700/1421/1628; Degeneration; Humanities and Social Sciences; Intervertebral discs; Longitudinal studies; Low back pain; Morphology; multidisciplinary; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-18984-1

Associations between multifidus muscle morphology and degenerative pathologies have been implied in patients with non-specific low back pain, but it is unknown how these are influenced by pathology severity, number, or distribution. MRI measures of pure multifidus muscle cross-sectional area (CSA) were acquired from 522 patients presenting with low back and/or leg symptoms in an outpatient clinic. We explored cross-sectional associations between the presence, distribution, and/or severity of lumbar degenerative pathologies (individually and in aggregate) and muscle outcomes in multivariable analyses (beta coefficients [95% CI]). We identified associations between lower pure multifidus muscle CSA and disc degeneration (at two or more levels): − 4.51 [− 6.72; − 2.3], Modic 2 changes: − 4.06 [− 6.09; − 2.04], endplate defects: − 2.74 [− 4.58; − 0.91], facet arthrosis: − 4.02 [− 6.26; − 1.78], disc herniations: − 3.66 [− 5.8; − 1.52], and when > 5 pathologies were present: − 6.77 [− 9.76; − 3.77], with the last supporting a potential dose–response relationship between number of spinal pathologies and multifidus morphology. Our findings could hypothetically indicate that these spinal and muscle findings: (1) are part of the same degenerative process, (2) result from prior injury or other common antecedent events, or (3) have a directional relationship. Future longitudinal studies are needed to further examine the complex nature of these relationships.