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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Geography of lumbar paravertebral muscle fatty infiltration
Authors: Crawford, Rebecca J.
Volken, Thomas
Mhuiris, Áine Ni
Bow, Cora C.
Elliott, James M.
Hoggarth, Mark A
Samartzis, Dino
DOI: 10.21256/zhaw-3231
Published in: Spine
Issue Date: 2019
Publisher / Ed. Institution: Lippincott Williams & Wilkins
ISSN: 0362-2436
Language: English
Subjects: Paravertebral; Muscle; Multifidus; Low back pain; Disability; Disc degeneration; Phenotype; Fatty infiltration
Subject (DDC): 616.7: Diseases of musculoskeletal system and orthopaedics
Abstract: 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.
Fulltext version: Accepted version
License (according to publishing contract): CC BY-NC-ND 4.0: Attribution - Non commercial - No derivatives 4.0 International
Restricted until: 2020-07-01
Departement: School of Health Sciences
Organisational Unit: Institute of Public Health (IPH)
Appears in collections:Publikationen Gesundheit

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Crawford, R. J., Volken, T., Mhuiris, Á. N., Bow, C. C., Elliott, J. M., Hoggarth, M. A., & Samartzis, D. (2019). Geography of lumbar paravertebral muscle fatty infiltration. Spine.
Crawford, R.J. et al. (2019) ‘Geography of lumbar paravertebral muscle fatty infiltration’, Spine [Preprint]. Available at:
R. J. Crawford et al., “Geography of lumbar paravertebral muscle fatty infiltration,” Spine, 2019, doi: 10.21256/zhaw-3231.
CRAWFORD, Rebecca J., Thomas VOLKEN, Áine Ni MHUIRIS, Cora C. BOW, James M. ELLIOTT, Mark A HOGGARTH und Dino SAMARTZIS, 2019. Geography of lumbar paravertebral muscle fatty infiltration. Spine. 2019. DOI 10.21256/zhaw-3231
Crawford, Rebecca J., Thomas Volken, Áine Ni Mhuiris, Cora C. Bow, James M. Elliott, Mark A Hoggarth, and Dino Samartzis. 2019. “Geography of Lumbar Paravertebral Muscle Fatty Infiltration.” Spine.
Crawford, Rebecca J., et al. “Geography of Lumbar Paravertebral Muscle Fatty Infiltration.” Spine, 2019,

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