{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:10:18Z","timestamp":1789567818436,"version":"build-2803163510"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lumbar spinal stenosis (LSS) causes nerve compression with low back pain and neurogenic claudication. Paraspinal muscles maintain lumbar stability, and coexisting lumbar segmental instability (LSI) may be associated with altered muscle morphology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare paraspinal muscle cross-sectional area (CSA) (psoas major, multifidus, erector spinae) in LSS patients with and without LSI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross-sectional study analyzed 97 patients with LSS. LSI was determined from flexion\u2013extension radiographs; 43 patients met LSI criteria. Paraspinal muscle CSA was measured at L4\u2013L5 using MRI. Independent t-tests or Mann-Whitney U tests compared CSA and pain characteristics including pain intensity (Numerical Rating Scale [NRS]) and pain duration (months). Multiplicity was controlled using Benjamini\u2013Hochberg false discovery rate (BH-FDR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Psoas major CSA was smaller in the LSI group bilaterally (right: mean difference \u2212166.50\u2005mm\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI \u2212301.42 to \u221231.58,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016, d\u2009=\u20090.49; left:\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.040, d\u2009=\u20090.43). Multifidus CSA was also smaller (right: mean difference \u221253.61\u2005mm\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI \u2212104.27 to \u22122.94,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.038, d\u2009=\u20090.43; left:\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.033, d\u2009=\u20090.44). However, there were no significant differences in the CSA of the erector spinae muscles and pain characteristics between groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LSS patients with concurrent LSI demonstrated significantly smaller CSA in local stabilizers (psoas major and multifidus) but not in global mobilizers (erector spinae). Pain characteristics did not differ between groups. These findings suggest that LSI has selective effects on paraspinal muscle morphology in LSS patients, supporting the importance of muscle morphological assessment in the clinical evaluation of patients with suspected segmental instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538127261488172","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:25:26Z","timestamp":1789446326000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of cross-sectional area for paraspinal muscles in patients with lumbar spinal stenosis with and without lumbar segmental instability: A retrospective cross-sectional study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7338-0265","authenticated-orcid":false,"given":"Jun-Su","family":"Ahn","sequence":"first","affiliation":[{"name":"Yonsei University"},{"name":"Department of Rehabilitation, Mirae\u2013bone Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2050-5503","authenticated-orcid":false,"given":"Ui-Jae","family":"Hwang","sequence":"additional","affiliation":[{"name":"The Hong Kong Polytechnic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Suk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mirae\u2013bone Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Gook","family":"Choi","sequence":"additional","affiliation":[{"name":"Kyung Hee Cyber University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9699-768X","authenticated-orcid":false,"given":"Oh-Yun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Yonsei University"},{"name":"Yonsei University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2022.12.013"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5921"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-230093"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03653-z"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007760300000"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-140578"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-9406(05)67048-4"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2024.103208"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0301726"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2015.07.006"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007760200034"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-230138"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2015.03.382"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-03596-w"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2009.11.006"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-2006-19101"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007760300031"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-023-05863-5"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2019.09.006"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2020.102224"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semss.2013.03.003"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.4172\/2167-7964.1000178"},{"key":"e_1_3_3_24_2","first-page":"1097","article-title":"Importance of lumbar instability in the study of associations between muscle morphology, pain, and disability in chronic low back pain","volume":"10","author":"Seyedhoseinpoor T","year":"2024","unstructured":"Seyedhoseinpoor T, Dadgoo M, Taghipour M, et al. Importance of lumbar instability in the study of associations between muscle morphology, pain, and disability in chronic low back pain. Am J Phys Med Rehabil 2024; 10: 1097.","journal-title":"Am J Phys Med Rehabil"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23893"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wnsx.2020.100077"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2018.08.002"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2451051359"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2023.06.398"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.4103\/sni.sni_359_17"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04854-w"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1050-6411(03)00044-0"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102504"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.18325\/jkmr.2016.26.1.95"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000144405.11661.eb"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2020.102245"},{"key":"e_1_3_3_37_2","volume-title":"Therapeutic exercise for spinal segmental stabilization in low back pain","author":"Richardson C","year":"1999","unstructured":"Richardson C, Jull G, Hides J, et al. Therapeutic exercise for spinal segmental stabilization in low back pain. Churchill Livingstone London, 1999."},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering10010067"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00333-5"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2019.102078"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2024.102949"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2023.01.007"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191610145"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2024.103124"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2024.102966"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2005.07.001"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2020.102190"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102655"},{"key":"e_1_3_3_49_2","article-title":"Systematic review of countermeasures to minimise physiological changes and risk of injury to the lumbopelvic area following long-term microgravity","volume":"27","author":"Winnard A","year":"2017","unstructured":"Winnard A, Nasser M, Debuse D, et al. Systematic review of countermeasures to minimise physiological changes and risk of injury to the lumbopelvic area following long-term microgravity. Musculoskelet Sci Pract 2017; 27: S5\u2013S14.","journal-title":"Musculoskelet Sci Pract"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2020.10.026"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-2010-0245"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2017.01.011"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199612010-00011"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-220409"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.28.2950"},{"key":"e_1_3_3_56_2","first-page":"101","article-title":"Lumbar multifidus muscle thickness during graded quadruped and prone exercises","volume":"14","author":"Dafkou K","year":"2021","unstructured":"Dafkou K, Kellis E, Ellinoudis A, et al. Lumbar multifidus muscle thickness during graded quadruped and prone exercises. Int J Exerc Sci 2021; 14: 101.","journal-title":"Int J Exerc Sci"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000241136.98159.8c"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2018.02.005"}],"container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538127261488172","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10538127261488172","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10538127261488172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:47:26Z","timestamp":1789566446000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10538127261488172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":57,"alternative-id":["10.1177\/10538127261488172"],"URL":"https:\/\/doi.org\/10.1177\/10538127261488172","relation":{},"ISSN":["1053-8127","1878-6324"],"issn-type":[{"value":"1053-8127","type":"print"},{"value":"1878-6324","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]},"article-number":"10538127261488172"}}