Spinal degeneration and lumbar multifidus muscle quality may independently affect clinical outcomes in patients conservatively managed for low back or leg pain

Jeffrey R. Cooley; Tue S. Jensen; Per Kjaer; Angela Jacques; Jean Theroux; Jeffrey J. Hebert

doi:10.1038/s41598-024-60570-0

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Spinal degeneration and lumbar multifidus muscle quality may independently affect clinical outcomes in patients conservatively managed for low back or leg pain

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Spinal degeneration and lumbar multifidus muscle quality may independently affect clinical outcomes in patients conservatively managed for low back or leg pain

Jeffrey R. Cooley, Tue S. Jensen, Per Kjaer, Angela Jacques, Jean Theroux and Jeffrey J. Hebert

Scientific reports, Vol.14(1), 9777

2024

DOI: https://doi.org/10.1038/s41598-024-60570-0

PMID: 38684854

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Abstract

Few non-surgical, longitudinal studies have evaluated the relations between spinal degeneration, lumbar multifidus muscle (LMM) quality, and clinical outcomes. None have assessed the potential mediating role of the LMM between degenerative pathology and 12-month clinical outcomes. This prospective cohort study used baseline and 12-month follow-up data from 569 patients conservatively managed for low back or back-related leg pain to estimate the effects of aggregate degenerative lumbar MRI findings and LMM quality on 12-month low back and leg pain intensity (0–10) and disability (0–23) outcomes, and explored the mediating role of LMM quality between degenerative findings and 12-month clinical outcomes. Adjusted mixed effects generalized linear models separately estimated the effect of aggregate spinal pathology and LMM quality. Mediation models estimated the direct and indirect effects of pathology on leg pain, and pathology and LMM quality on leg pain, respectively. Multivariable analysis identified a leg pain rating change of 0.99 [0.14; 1.84] (unstandardized beta coefficients [95% CI]) in the presence of ≥ 4 pathologies, and a disability rating change of − 0.65 [− 0.14; − 1.16] for each 10% increase in muscle quality, but no effect on back pain intensity. Muscle quality had a non-significant mediating role (13.4%) between pathology and leg pain intensity. The number of different pathologies present demonstrated a small effect on 12-month leg pain intensity outcomes, while higher LMM quality had a direct effect on 12-month disability ratings but no mediating effect between pathology and leg pain. The relations between degenerative pathology, LMM quality, and pain-related outcomes appear complex and may include independent pathways.

Details

Title: Spinal degeneration and lumbar multifidus muscle quality may independently affect clinical outcomes in patients conservatively managed for low back or leg pain
Authors/Creators: Jeffrey R. Cooley - Murdoch University
Tue S. Jensen - Silkeborg, Denmark Middelfart, Denmark Odense M, Denmark Odense M, Denmark
Per Kjaer - Odense M, Denmark Odense M, Denmark
Angela Jacques - The University of Notre Dame Australia
Jean Theroux - 90 South Street, Murdoch, WA 6150 Australia
Jeffrey J. Hebert - 90 South Street, Murdoch, WA 6150 Australia Fredericton, NB Canada
Publication Details: Scientific reports, Vol.14(1), 9777
Publisher: Nature Publishing Group UK
Identifiers: 991005659469807891
Murdoch Affiliation: Murdoch University
Language: English
Resource Type: Journal article

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