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Links among <scp>MRI</scp> features in paraspinal muscles, inflammatory processes, and related back pain in patients with lumbar disc herniation

Xiaolong Chen, Peng Cui, Yongjin Li, Yu Wang, Shibao Lu

2023JOR Spine15 citationsDOIOpen Access PDF

Abstract

Background: Recent studies have provided evidence that structural changes in paraspinal muscles are associated with intervertebral disc degeneration (IDD), ubiquitous with low back pain (LBP), and potentially thought to be regulated by inflammatory processes. However, the links remain unclear. Objective: The aims of this study were to investigate structural changes in paraspinal muscles that differed in healthy and lumbar disc herniation (LDH) patients, and LDH patients with and without LBP, and to determine the link with the expression of inflammatory marker(s). Methods: -test, Chi-square, and Spearman correlation were used for evaluating the links among structural changes, expression of inflammatory markers, and clinical outcomes. Results: Functional CSA and fatty degeneration of MM were larger in healthy group than LDH group. A significant increase in fat infiltration in MM in LBP group than in non-LBP group. TNF-alpha (TNF-α) was 28-fold greater in high-fat infiltration group than low-fat infiltration group within MM. Expression of TNF-α and IL-1β in MM was moderately correlated with functional CSA and fatty degeneration of MM, which was moderately correlated with clinical outcomes. Conclusions: Results support the hypothesis that IDD is associated with dysregulation of inflammatory state of local MM, which provides initial evidence that inflammatory dysregulation in paraspinal muscles has the potential for a broad impact on tissue health and LBP symptoms.

Topics & Concepts

MedicineLow back painLumbarMultifidus muscleInflammationIntervertebral discInfiltration (HVAC)Degeneration (medical)Internal medicinePathologyProspective cohort studySurgeryAlternative medicinePhysicsThermodynamicsSpine and Intervertebral Disc PathologyMusculoskeletal pain and rehabilitationPain Mechanisms and Treatments