Article

OBJECTIVE: To determine whether lumbar muscle characteristics on magnetic
resonance imaging (MRI) or computed tomography (CT) can inform clinicians as to
the course of future low back pain (LBP), functional limitations, or physical
performance, in adults with or without LBP. TYPE: Systematic review. LITERATURE REVIEW: We searched PubMed, Embase, and CINAHL through October 2014 for articles
published in English in which authors assessed lumbar muscle characteristics on
conventional MRI/CT as predictors of future LBP, functional limitations, or
physical performance in adults. Studies with only postsurgical subjects were
excluded. Our search identified 3554 articles, of which 6 observational cohort
studies were included in the final review. METHODOLOGY: We used the Newcastle
Ottawa Scale to evaluate potential bias. Data were extracted on study design,
study population, sample size, participant characteristics, details of MRI/CT
assessments, interventions, study outcomes, analysis methods, and study results.
Because of heterogeneity between studies, we conducted a qualitative evidence
synthesis. SYNTHESIS: Among high-quality studies, there was limited evidence
that, for individuals with or without LBP, greater MRI-detected multifidus
cross-sectional area at L5-S1 predicted greater LBP intensity at 1-year
follow-up, lesser erector spinae fat infiltration (FI) at L5-S1 predicted greater
LBP intensity at 15-year follow-up, and greater erector spinae side-to-side FI
asymmetry at L3-L4 predicted lower LBP frequency at 15-year follow-up; however,
there was also limited evidence that all other MRI-detected paraspinal muscle
characteristics examined were not predictive of LBP incidence, prevalence,
frequency, or intensity at follow-up durations ranging from 1 to 15 years. There
was limited evidence that greater CT-detected trunk muscle FI predicted worse
physical performance in older adults at 3-year follow-up, but that trunk muscle
cross-sectional area did not. CONCLUSION: Few lumbar muscle characteristics have
limited evidence for an association with future LBP and physical performance
outcomes, and the vast majority have limited evidence for having no association
with such outcomes.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc.
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Langue : ANGLAIS