Ranger, TA and Teichtahl, AJ and Cicuttini, FM and Wang, Y and Wluka, AE and O'Sullivan, R and Jones, G and Urquhart, DM, Shorter lumbar paraspinal fascia is associated with high intensity low back pain and disability, Spine, 41, (8) pp. E489-E493. ISSN 0362-2436 (2016) [Refereed Article]
|PDF (Accepted version)|
Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. The Authors Accepted manuscript is not the final published version.
Study Design: A cross-sectional, community-based study.
Objective: The aim of this study was to investigate the relationship between structural features of the thoracolumbar fascia and low back pain and disability.
Summary of Background Data: The thoracolumbar fascia plays a role in stabilization of the spine by transmitting tension from the spinal and abdominal musculature to the vertebrae. It has been hypothesized that the fascia is associated with low back pain through the development of increased pressure in the paraspinal compartment, which leads to muscle ischemia.
Methods: Seventy-two participants from a community-based study of musculoskeletal health underwent Magnetic Resonance Imaging from the T12 vertebral body to the sacrum. The length of the paraspinal fascia and cross-sectional area of the paraspinal compartment were quantitatively measured from axial images at the level of the transverse processes and the Chronic Pain Grade Scale was used to assess low back pain intensity and disability.
Results: A shorter length of fascia around the parapsinal compartment was significantly associated with high intensity low back pain and/or disability, after adjusting for age, gender, and body mass index [right odds ratio (OR) 1.9, 95% CI 0.99–3.8, P = 0.05; left OR 2.6, 95% CI 1.2 to 5.6, P = 0.01). Further adjustment for the cross-sectional area of the compartment strengthened the associations between fascial length and low back pain/or disability (right OR 8.9, 95% CI 1.9–40.9, P = 0.005; left OR 9.6, 95% CI 1.2–42.9, P = 0.003).
Conclusion: This study has demonstrated that a shorter lumbar paraspinal fascia is associated with high intensity low back pain and/or disability among community-based adults. Although cohort studies are needed, these results suggest that structural features of the fascia may play a role in high levels of low back pain and disability.
|Item Type:||Refereed Article|
|Keywords:||low back pain, disability, thoracolumbar fascia, epidemiology, spine structure, paraspinal compartment|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Rheumatology and Arthritis|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Skeletal System and Disorders (incl. Arthritis)|
|Author:||Jones, G (Professor Graeme Jones)|
|Year Published:||2016 (online first 2015)|
|Web of Science® Times Cited:||3|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||20 View Download Statistics|
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