{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T21:01:25Z","timestamp":1787950885733,"version":"build-2784847793"},"reference-count":44,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thespinejournalonline.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Spine Journal"],"published-print":{"date-parts":[[2020,10]]},"DOI":"10.1016\/j.spinee.2020.04.007","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T02:19:54Z","timestamp":1587349194000},"page":"1573-1585","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":64,"title":["Unilateral changes of the multifidus in persons with lumbar disc herniation: a systematic review and meta-analysis"],"prefix":"10.1016","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3394-146X","authenticated-orcid":false,"given":"Sjoerd","family":"Stevens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"Agten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Timmermans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Vandenabeele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.spinee.2020.04.007_bib0001","first-page":"1988","article-title":"Incidence of low back pain after lumbar discectomy for herniated disc and its effect on patient-reported outcomes","volume":"473","author":"Parker","year":"2015","journal-title":"ClinOrthopRelat Res"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0002","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.spinee.2017.08.264","article-title":"A minimum of 5-year follow-up after lumbar transforaminal epidural steroid injections in patients with lumbar radicular pain due to intervertebral disc herniation","volume":"18","author":"Kennedy","year":"2018","journal-title":"Spine J"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0003","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s00586-009-1171-x","article-title":"Differentiation between deep and superficial fibers of the lumbar multifidus by magnetic resonance imaging","volume":"19","author":"Dickx","year":"2010","journal-title":"Eur Spine J"},{"issue":"10","key":"10.1016\/j.spinee.2020.04.007_bib0004","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1016\/j.jbiomech.2008.09.042","article-title":"Passive mechanical properties of the lumbar multifidus muscle support its role as a stabilizer","volume":"42","author":"Ward","year":"2009","journal-title":"J Biomech"},{"issue":"4","key":"10.1016\/j.spinee.2020.04.007_bib0005","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1055\/s-0038-1639332","article-title":"Paraspinal muscles of patients with lumbar diseases","volume":"79","author":"Park","year":"2018","journal-title":"J Neurol Surg Part A, Cent Eur Neurosurg"},{"issue":"11","key":"10.1016\/j.spinee.2020.04.007_bib0006","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1016\/j.spinee.2017.07.002","article-title":"Are the size and composition of the paraspinal muscles associated with low back pain? A systematic review","volume":"17","author":"Ranger","year":"2017","journal-title":"Spine J"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0007","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12891-016-1376-1","article-title":"Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain","volume":"18","author":"Hildebrandt","year":"2017","journal-title":"BMC Musculoskel Disord"},{"key":"10.1016\/j.spinee.2020.04.007_bib0008","first-page":"19","article-title":"Relationships between paraspinal muscle morphology and neurocompressive conditions of the lumbar spine: a systematic review with meta-analysis","author":"Cooley","year":"2018","journal-title":"BMC Musculoskel Disord"},{"issue":"7","key":"10.1016\/j.spinee.2020.04.007_bib0009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"issue":"6","key":"10.1016\/j.spinee.2020.04.007_bib0010","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/jech.52.6.377","article-title":"The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions","volume":"52","author":"Downs","year":"1998","journal-title":"J Epidemiol Community Health"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0011","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jsams.2009.03.004","article-title":"Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis","volume":"13","author":"Munn","year":"2010","journal-title":"J Sci Med Sport"},{"issue":"7414","key":"10.1016\/j.spinee.2020.04.007_bib0012","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"issue":"2","key":"10.1016\/j.spinee.2020.04.007_bib0013","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/jrsm.1044","article-title":"Consistency and inconsistency in network meta-analysis: concepts and models for multi-arm studies","volume":"3","author":"Higgins","year":"2012","journal-title":"Res Synth Methods"},{"issue":"6","key":"10.1016\/j.spinee.2020.04.007_bib0014","first-page":"235","article-title":"Muscle fiber type distribution in multifidus muscle in cases of lumbar disc herniation","volume":"54","author":"Bajek","year":"2000","journal-title":"Acta Med Okayama"},{"issue":"2","key":"10.1016\/j.spinee.2020.04.007_bib0015","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1159\/000145737","article-title":"Analysis of vertebral muscle obtained during surgery for correction of a lumbar disc disorder","volume":"116","author":"Ford","year":"1983","journal-title":"ActaAnat (Basel)"},{"issue":"21","key":"10.1016\/j.spinee.2020.04.007_bib0016","doi-asserted-by":"crossref","first-page":"E598","DOI":"10.1097\/BRS.0b013e318155837b","article-title":"Asymmetric atrophy of multifidus muscle in patients with unilateral lumbosacral radiculopathy","volume":"32","author":"Hyun","year":"2007","journal-title":"Spine"},{"issue":"5","key":"10.1016\/j.spinee.2020.04.007_bib0017","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/PHM.0b013e31819c506d","article-title":"Multifidus morphology in persons scheduled for single-level lumbar microdiscectomy: qualitative and quantitative assessment with anatomical correlates","volume":"88","author":"Kulig","year":"2009","journal-title":"Am J Phys Med Rehabil"},{"issue":"3","key":"10.1016\/j.spinee.2020.04.007_bib0018","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/00007632-198903000-00010","article-title":"Connective tissue changes of the multifidus muscle in patients with lumbar disc herniation. An immunohistologic study of collagen types I and III and fibronectin","volume":"14","author":"Lehto","year":"1989","journal-title":"Spine."},{"issue":"7","key":"10.1016\/j.spinee.2020.04.007_bib0019","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1097\/00007632-198609000-00013","article-title":"The multifidus muscle in patients with lumbar disc herniation. A histochemical and morphometric analysis of intraoperative biopsies.","volume":"11","author":"Mattila","year":"1986","journal-title":"Spine"},{"issue":"5","key":"10.1016\/j.spinee.2020.04.007_bib0020","doi-asserted-by":"crossref","first-page":"493","DOI":"10.3928\/0147-7447-20030501-14","article-title":"Atrophy of the multifidus muscle in patients with lumbar disk herniation: histochemical and electromyographic study","volume":"26","author":"Yoshihara","year":"2003","journal-title":"Orthopedics"},{"issue":"10","key":"10.1016\/j.spinee.2020.04.007_bib0021","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.spinee.2012.08.020","article-title":"Is level- and side-specific multifidus asymmetry a marker for lumbar disc pathology?","volume":"12","author":"Battie","year":"2012","journal-title":"Spine J"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0022","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1589\/jpts.26.37","article-title":"A study on dispersion and rate of fat infiltration in the lumbar spine of patients with herniated nucleus polpusus","volume":"26","author":"Kong","year":"2014","journal-title":"Journal of physical therapy science"},{"issue":"1004","key":"10.1016\/j.spinee.2020.04.007_bib0023","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1259\/bjr\/58136533","article-title":"Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease","volume":"84","author":"Ploumis","year":"2011","journal-title":"Br J Radiol"},{"issue":"6","key":"10.1016\/j.spinee.2020.04.007_bib0024","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/00007632-200103150-00012","article-title":"Histochemical changes in the multifidus muscle in patients with lumbar intervertebral disc herniation","volume":"26","author":"Yoshihara","year":"2001","journal-title":"Spine"},{"issue":"17","key":"10.1016\/j.spinee.2020.04.007_bib0025","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1097\/00007632-200009010-00009","article-title":"Histochemistry and morphology of the multifidus muscle in lumbar disc herniation: comparative study between diseased and normal sides","volume":"25","author":"Zhao","year":"2000","journal-title":"Spine"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0026","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s00256-015-2252-z","article-title":"Lumbar multifidus muscle changes in unilateral lumbar disc herniation using magnetic resonance imaging","volume":"45","author":"Altinkaya","year":"2016","journal-title":"Skeletal Radiol"},{"issue":"5","key":"10.1016\/j.spinee.2020.04.007_bib0027","doi-asserted-by":"crossref","first-page":"801","DOI":"10.5535\/arm.2017.41.5.801","article-title":"Asymmetric atrophy of paraspinal muscles in patients with chronic unilateral lumbar radiculopathy","volume":"41","author":"Chon","year":"2017","journal-title":"Ann Rehabil Med"},{"issue":"1","key":"10.1016\/j.spinee.2020.04.007_bib0028","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00256-013-1748-7","article-title":"Asymmetry of the multifidus muscle in lumbar radicular nerve compression","volume":"43","author":"Farshad","year":"2014","journal-title":"Skeletal Radiol"},{"issue":"5","key":"10.1016\/j.spinee.2020.04.007_bib0029","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1007\/s00586-016-4503-7","article-title":"Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation","volume":"25","author":"Fortin","year":"2016","journal-title":"Eur Spine jJ"},{"issue":"3","key":"10.1016\/j.spinee.2020.04.007_bib0030","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3340\/jkns.2011.50.3.201","article-title":"Changes in the cross-sectional area of multifidus and psoas in unilateral sciatica caused by lumbar disc herniation","volume":"50","author":"Kim","year":"2011","journal-title":"J Korean Neurosurg Soc"},{"issue":"8","key":"10.1016\/j.spinee.2020.04.007_bib0031","doi-asserted-by":"crossref","first-page":"3590","DOI":"10.1177\/0300060519853430","article-title":"Evaluation of lumbar multifidus muscle in patients with lumbar disc herniation: are complex quantitative MRI measurements needed?","volume":"47","author":"Colakoglu","year":"2019","journal-title":"J Int Med Res"},{"issue":"4","key":"10.1016\/j.spinee.2020.04.007_bib0032","doi-asserted-by":"crossref","first-page":"e35273","DOI":"10.1371\/journal.pone.0035273","article-title":"Rapid determination of myosin heavy chain expression in rat, mouse, and human skeletal muscle using multicolor immunofluorescence analysis","volume":"7","author":"Bloemberg","year":"2012","journal-title":"PLoS One"},{"issue":"2","key":"10.1016\/j.spinee.2020.04.007_bib0033","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.spinee.2019.09.023","article-title":"Biopsy samples from the erector spinae of persons with nonspecific chronic low back pain (NSCLBP) display a decrease in glycolytic muscle fibers","volume":"20","author":"Agten","year":"2020","journal-title":"Spine J"},{"issue":"2","key":"10.1016\/j.spinee.2020.04.007_bib0034","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/00007632-199401001-00009","article-title":"Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute\/subacute low back pain","volume":"19","author":"Hides","year":"1994","journal-title":"Spine"},{"issue":"2","key":"10.1016\/j.spinee.2020.04.007_bib0035","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1007\/s00586-007-0529-1","article-title":"Polysegmental innervation of the medial paraspinal lumbar muscles","volume":"17","author":"Kottlors","year":"2008","journal-title":"Eur Spine J"},{"issue":"25","key":"10.1016\/j.spinee.2020.04.007_bib0036","doi-asserted-by":"crossref","first-page":"2926","DOI":"10.1097\/01.brs.0000248453.51165.0b","article-title":"Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury","volume":"31","author":"Hodges","year":"2006","journal-title":"Spine"},{"issue":"13","key":"10.1016\/j.spinee.2020.04.007_bib0037","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1097\/BRS.0000000000000318","article-title":"Can proinflammatory cytokine gene expression explain multifidus muscle fiber changes after an intervertebral disc lesion?","volume":"39","author":"Hodges","year":"2014","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2020.04.007_bib0038","first-page":"eS581","article-title":"Multifidus muscle undergoes structural remodeling of muscle, adipose and connective tissue, but not atrophy after injury: Molecular and morphological evidence","volume":"101","author":"Hodges","year":"2015","journal-title":"Physiotherapy (United Kingdom)"},{"key":"10.1016\/j.spinee.2020.04.007_bib0039","doi-asserted-by":"crossref","DOI":"10.1007\/s00586-018-5652-7","article-title":"Macrophage polarization contributes to local inflammation and structural change in the multifidus muscle after intervertebral disc injury","author":"James","year":"2018","journal-title":"Eur Spine J"},{"issue":"12","key":"10.1016\/j.spinee.2020.04.007_bib0040","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1002\/jor.23597","article-title":"Lumbar multifidus muscle degenerates in individuals with chronic degenerative lumbar spine pathology","volume":"35","author":"Shahidi","year":"2017","journal-title":"J Orthop Res"},{"issue":"12","key":"10.1016\/j.spinee.2020.04.007_bib0041","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1038\/embor.2013.182","article-title":"Cellular dynamics in the muscle satellite cell niche","volume":"14","author":"Bentzinger","year":"2013","journal-title":"EMBO Rep"},{"issue":"11","key":"10.1016\/j.spinee.2020.04.007_bib0042","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1111\/febs.14417","article-title":"Chronic inflammation in skeletal muscle impairs satellite cells function during regeneration: can physical exercise restore the satellite cell niche?","volume":"285","author":"Perandini","year":"2018","journal-title":"FEBS J"},{"issue":"5","key":"10.1016\/j.spinee.2020.04.007_bib0043","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.12012","article-title":"Endurance interval training in obese mice reduces muscle inflammation and macrophage content independently of weight loss","volume":"2","author":"Samaan","year":"2014","journal-title":"Physiol Rep"},{"issue":"5","key":"10.1016\/j.spinee.2020.04.007_bib0044","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1007\/s00586-019-05902-9","article-title":"ISSLS Prize in Basic science 2019: physical activity attenuates fibrotic alterations to the multifidus muscle associated with intervertebral disc degeneration","volume":"28","author":"James","year":"2019","journal-title":"Eur Spine J"}],"container-title":["The Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152994302030142X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152994302030142X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:33:57Z","timestamp":1761514437000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S152994302030142X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":44,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["S152994302030142X"],"URL":"https:\/\/doi.org\/10.1016\/j.spinee.2020.04.007","relation":{},"ISSN":["1529-9430"],"issn-type":[{"value":"1529-9430","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Unilateral changes of the multifidus in persons with lumbar disc herniation: a systematic review and meta-analysis","name":"articletitle","label":"Article Title"},{"value":"The Spine Journal","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.spinee.2020.04.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}