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Magnetic resonance spectroscopic analysis of multifidus muscles lipid content and association with spinopelvic malalignment in chronic low back pain.

OBJECTIVE
To analyze intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) of the multifidus muscle (Mm) using MR spectroscopy in chronic low back pain (CLBP) and control groups and to identify correlations with spinopelvic alignment.


METHODS
40 patients (16 males, 24 females; mean age, 62.9 ± 1.9 years) whose visual analogue scale scores were >30 mm for CLBP were included. Furthermore, 40 control participants matched with the CLBP group subjects by sample size, gender and age (17 males, 23 females; mean age, 65.0 ± 1.2 years) were included. We compared the body mass index, physical workload, leisure time physical activity level, spinopelvic parameters, and IMCLs and EMCLs of the Mm between the groups. We also evaluated possible correlations of spinopelvic parameters with IMCLs and EMCLs of the Mm in the groups.


RESULTS
There were no statistically significant differences in body mass index, physical workload, exercise intensity level, spinopelvic parameters and EMCLs between the groups. The IMCLs were significantly higher in the CLBP group than in the control group (p < 0.01). In the CLBP group, there was a significantly negative correlation between IMCLs and lumbar lordosis (r = -0.64, p < 0.01) and a significantly positive correlation between IMCLs and sagittal vertical axis (r = 0.43, p < 0.01).


CONCLUSION
The measurement of IMCLs might be a characteristic finding of CLBP as well as a precursor to spinal deformity. Advances in knowledge: IMCLs of the Mm may be a useful prognostic marker in rehabilitation strategies for patients with CLBP.