Are paraspinal muscle quantity, lumbar indentation value, and subcutaneous fat thickness related to disc degeneration? An MRI-based study

Fear of movement in patients after lumbar spine fusion and an analysis of factors: a cross-sectional study

BACKGROUND

Numerous studies have confirmed the significant benefits of exercise rehabilitation in both preoperative and postoperative treatment of lumbar disc herniation. However, there is a prevalent fear or avoidance of exercise among patients with chronic low back pain prior to surgery, while research on exercise fear after lumbar fusion remains insufficient. This study aims to investigate the incidence and severity of exercise fear in patients with chronic low back pain and leg pain following lumbar fusion surgery, as well as analyze its underlying mechanism and associated risk factors.

METHODS

A cross-sectional study was conducted on patients undergoing posterior lumbar fusion for lumbar disc herniation between May 2023 and January 2024. The Tampa Motor Phobia Scale (TSK-17) was utilized to assess motor fear among participants. Additionally, clinical and imaging risk factors were analyzed through multivariate regression analysis to determine relevant influencing factors.

RESULTS

Following strict inclusion and exclusion criteria, a total of 178 patients who underwent posterior lumbar fusion were included in this study, comprising 104 males (58.4%). Kinesiophobia was defined as a TSK-17 score ≥ 37, which identified 65.2% (116/178) of the screened patients exhibiting motor phobia. Multivariate regression analysis revealed that motor phobia was strongly associated with age, higher levels of pain intensity, elevated Beck Depression Inventory (BDI) scores, lower General Self-Efficacy Scale (GSES) scores, increased number of surgical levels involved during operation, greater amount of postoperative incision drainage, higher degree of nerve root compression observed on preoperative lumbar MRI scans, as well as smaller area occupied by the paravertebral muscles in the lumbar region.

CONCLUSION

This study has identified a significantly high incidence of postoperative exercise fear in patients undergoing posterior lumbar fusion, along with potential risk factors. Therefore, it is crucial for clinicians to closely evaluate and monitor these patients in order to develop appropriate strategies for postoperative exercise rehabilitation.

Application of MRI imaging parameters in lumbar spine diseases: a review of the literature

AIM

The purpose of this study is to review the application of MRI imaging parameters in lumbar degenerative diseases (LDD) and related complications after lumbar surgery, and to explore its application scope, advantages and diagnostic value.

MATERIALS AND METHODS

This study provides a comprehensive review of the application of MRI imaging parameters in LDD. The measurement methods of each imaging parameter were described in detail, and the clinical significance of each parameter in LDD and postoperative complications of lumbar spine was summarized.

RESULTS

Studies have shown that reduced paraspinal muscle cross-sectional area (CSA), increased fat infiltration rate (FIR), and smaller lumbar depression value (LIV) are risk factors for the development of LDD and postoperative complications of lumbar spine (vertebral fracture, screw loosening, cage subsidence, etc). The vertebral bone quality (VBQ) score reflects vertebral bone quality and correlates significantly with DXA T-value and QCT BMD value, which can effectively identifying patients with osteopenia or normal bone quality. At the same time,elevated VBQ score is a significant predictor of the occurrence of osteoporosis, postoperative screw loosening and fusion cage subsidence in the lumbar spine.

CONCLUSION

Our study showed that MRI imaging-related parameters are widely used in clinical practice, which can quantitatively reflect the quality of paravertebral muscles, the degree of fat infiltration, and vertebral bone density. They have important guiding significance for the diagnosis, treatment and prognosis of lumbar spine diseases.

Association between the Thickness of Lumbar Subcutaneous Fat Tissue and the Presence of Hernias in Adults with Persistent, Non-Traumatic Low Back Pain

We aimed to analyze the association between the average lumbar subcutaneous fat tissue thickness (LSFTT) at each intervertebral level and the presence of hernias in patients with low back pain from an insurance network hospital in Mexico. This observational prospective study included 174 patients with non-traumatic lumbago who underwent magnetic resonance imaging with a 1.5T resonator. Two independent radiologists made the diagnosis, and a third specialist provided a quality vote when needed. The sample size was calculated with a 95% confidence interval using random order selection. Anonymized secondary information was used. Percentages and means with confidence intervals were tabulated. The area under the curve, specificity, and sensitivity of LSFTT were calculated. A regression analysis was performed to analyze the presence of hernias with LSFTT using each intervertebral level as a predictor. The odds of herniation at any intervertebral level increased directly with LSFTT. The average LSFTT predicted the overall presence of hernias; however, the LSFTT at each intervertebral level better predicted hernias for each intervertebral space. The area under the curve for LSFTT in predicting hernias was 68%. In conclusion, the average LSFTT was associated with the overall presence of hernias; patients with more hernias had higher LSFTT values.