title: Magnetic resonance spectroscopic analysis of multifidus muscles lipid content and association with spinopelvic malalignment in chronic low back pain.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Izaya
authors.initials: I
authors.lastname: Ogon
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takebayashi
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takashima
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Yoshimoto
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Terashima
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000150:complications / Q000378:metabolism; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008055:Lipids; D017116:Low Back Pain / Q000150:complications* / Q000378:metabolism; D008159:Lumbar Vertebrae; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064170:Paraspinal Muscles / Q000000981:diagnostic imaging / Q000378:metabolism*; D010388:Pelvis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013131:Spine / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D008055:Lipids