title: Evaluation of intramyocellular and extramyocellular lipids in the paraspinal muscle in patients with chronic low back pain using MR spectroscopy: preliminary results.
abstract: To analyze the intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) in the psoas muscle (Pm) and multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with chronic low back pain (CLBP) and asymptomatic volunteers.
  This prospective study had institutional review board approval, and written informed consent was obtained from all individual participants. 20 patients with CLBP (mean age, 49.8 ± 12.5 years; age range, 28-66 years) with low back pain (LBP) duration of ≥3 months and asymptomatic volunteers (mean age, 44.0 ± 12.8 years; age range, 28-65 years) underwent MRS for the quantification of IMCL and EMCL of the right Pm and Mm in a volume of interest at the intervertebral level of L4 through L5. We compared patients with CLBP and asymptomatic volunteers for age and body mass index (BMI), IMCL and EMCL of Pm and Mm. The Mann-Whitney U-test was used for significant difference testing, with p-value <0.05 indicating statistical significance.
  No statistically significant differences were observed in the age and BMI of patients with CLBP and asymptomatic volunteers. There was no statistically significant difference in the EMCL and IMCL in Pm between the two groups. EMCL in Mm was not statistically significantly different; the IMCL of patients with CLBP was significantly higher than that of asymptomatic volunteers (p < 0.05).
  MRS demonstrates that IMCL in the Mm of patients with CLBP is significantly higher than that of asymptomatic volunteers. The increase of IMCL in the Mm may be a characteristic finding in CLBP.
  We investigated the detail of the fat content in the paraspinal muscles in patients CLBP and asymptomatic volunteers. The increase of fat content in the Mm of patients with LBP on previous studies was demonstrated to be the increase of IMCL.
authors.affiliation: 1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.|2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takashima
authors.affiliation: 1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takebayashi
authors.affiliation: 1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Izaya
authors.initials: I
authors.lastname: Ogon
authors.affiliation: 1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Yoshimoto
authors.affiliation: 1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Terashima
authors.affiliation: 2 Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Japan.
authors.forename: Rui
authors.initials: R
authors.lastname: Imamura
authors.affiliation: 1 Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita