Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: The politics of chronic LBP: can we rely on a proxy-vote? : linking multifidus intra-myo-cellular lipid (IMCL) fatty infiltration with arthrogenic muscle inhibition induced chronic non-specific low back pain
Authors: Gabel, Charles Philip
Mokhtarinia, Hamid Reza
Melloh, Markus
et. al: No
DOI: 10.1097/BRS.0000000000003758
Published in: Spine
Volume(Issue): 46
Issue: 2
Pages: 129
Pages to: 130
Issue Date: 19-Oct-2020
Publisher / Ed. Institution: Lippincott Williams & Wilkins
ISSN: 0362-2436
Language: English
Subjects: Arthrogenic Muscle Inhibition (AMI); Intra-Myo-Cellular Lipid (IMCL); Multifidus; Chronic Low Back Pain (CLBP)
Subject (DDC): 617.5: Orthopaedic surgery
Abstract: Study Design Retrospective review of the literature. Objective To update recent trends in the use of magnetic resonance spectroscopy (MRS) analysis for chronic low back pain (CLBP). Summary of Background Data The lumbar multifidus muscle (MF) has drawn sustained interest for some time, particularly related to its structure, role in spinal stability, and its association and clinical significance with CLBP. Additionally, the presence of MF arthrogenic muscle inhibition (AMI) and its relation to induced CLBP, through depleted lumbar stabilization, has gained increased recognition. In contrast, the differential diagnostic use of MRS analysis has suggested specific links between the presence of MF myocellular lipid (MCL) infiltration and CLBP patients. Methods Review of the literature related to CLBP with the keywords MCL, MRS analysis and MF-AMI. Results No articles discussed CLBP using the three key concepts in a single context. The use of MRS analysis has the capacity to distinguish between extra-MCL (EMCL) and intra-MCL (IMCL) infiltration within the lumbar MF. It is suggested that EMCLs are more likely to be associated with age related change, while the IMCLs appear more likely to be associated with the presence of CLBP. The increased recognition of MF-AMI as a primary cause of CLBP, and the potential that AMI parallels the presence of IMCLs, facilitates possible use of MRS as a means to quantify the basis of lumbar MF-AMI CLBP, and that proportional IMCL changes in the MF could serve as a ‘proxy’ to indicate the effectiveness of interventions directed at MF activation. Conclusions It may be possible for IMCLs to serve as a ‘proxy’ prognostic marker of lumbar MF-AMI in CLBP patients. Further, if this assertion were correct, then reductions in IMCLs could potentially quantify recovery and the efficacy of rehabilitation management strategies directed at lumbar MF activation.
Fulltext version: Published version
License (according to publishing contract): Licence according to publishing contract
Departement: School of Health Sciences
Organisational Unit: Institute of Public Health (IPH)
Appears in collections:Publikationen Gesundheit

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