{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:54:16Z","timestamp":1791806056287,"version":"4.3.4"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>In chronic low back pain (CLBP), the relationship between spinal pathologies and paraspinal muscles fat infiltration remains unclear. This study aims to evaluate the relationship between MRI findings and paraspinal muscles morphology and fat infiltration in CLBP patients by quantitative MRI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>All the CLBP patients were enrolled from July 2021 to December 2022 in four medical institutions. The cross-sectional area (CSA) and proton density fat fraction (PDFF) of the multifidus (MF) and erector spinae (ES) muscles at the central level of the L4\/5 and L5\/S1 intervertebral discs were measured. MRI findings included degenerative lumbar spondylolisthesis (DLS), intervertebral disc degeneration (IVDD), facet arthrosis, disc bulge or herniation, and disease duration. The relationship between MRI findings and the paraspinal muscles PDFF and CSA in CLBP patients was analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 493 CLBP patients were included in the study (198 females, 295 males), with an average age of 45.68\u2009\u00b1\u200912.91 years. Our research indicates that the number of MRI findings are correlated with the paraspinal muscles PDFF at the L4\/5 level, but is not significant. Moreover, the grading of IVDD is the primary factor influencing the paraspinal muscles PDFF at the L4-S1 level (B<jats:sub>ES at L4\/5<\/jats:sub>=1.845, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05); DLS was a significant factor affecting the PDFF of MF at the L4\/5 level (B\u2009=\u20094.774, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). After including age, gender, and Body Mass Index (BMI) as control variables in the multivariable regression analysis, age has a significant positive impact on the paraspinal muscles PDFF at the L4-S1 level, with the largest AUC for ES PDFF at the L4\/5 level (AUC\u2009=\u20090.646, cut-off value\u2009=\u200947.5), while males have lower PDFF compared to females. BMI has a positive impact on the ES PDFF only at the L4\/5 level (AUC\u2009=\u20090.559, cut-off value\u2009=\u200924.535).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The degree of paraspinal muscles fat infiltration in CLBP patients is related to the cumulative or synergistic effects of multiple factors, especially at the L4\/L5 level. Although age and BMI are important factors affecting the degree of paraspinal muscles PDFF in CLBP patients, their diagnostic efficacy is moderate.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-024-07649-x","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T03:41:24Z","timestamp":1721101284000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Association of MRI findings with paraspinal muscles fat infiltration at lower lumbar levels in patients with chronic low back pain: a multicenter prospective study"],"prefix":"10.1186","volume":"25","author":[{"given":"Heyi","family":"Gu\u2020","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingrui","family":"Hong\u2020","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanming","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingbin","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenguang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"issue":"10137","key":"7649_CR1","doi-asserted-by":"publisher","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","volume":"391","author":"J Hartvigsen","year":"2018","unstructured":"Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention[J]. Lancet. 2018;391(10137):2356\u201367.","journal-title":"Lancet"},{"issue":"6","key":"7649_CR2","doi-asserted-by":"publisher","first-page":"299","DOI":"10.21037\/atm.2020.02.175","volume":"8","author":"A Wu","year":"2020","unstructured":"Wu A, March L, Zheng X, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the global burden of Disease Study 2017[J]. Ann Transl Med. 2020;8(6):299.","journal-title":"Ann Transl Med"},{"key":"7649_CR3","doi-asserted-by":"crossref","unstructured":"Urits Ivan B, Aaron S, Medha, et al. Low back Pain, a Comprehensive Review: pathophysiology, diagnosis, and Treatment[J]. Volume 23. Current Pain and Headache Reports; 2019. 3.","DOI":"10.1007\/s11916-019-0757-1"},{"issue":"6","key":"7649_CR4","doi-asserted-by":"publisher","first-page":"464","DOI":"10.2519\/jospt.2019.8827","volume":"49","author":"PW Hodges","year":"2019","unstructured":"Hodges PW, Danneels L. Changes in structure and function of the Back muscles in low back Pain: different time points, observations, and Mechanisms[J]. J Orthop Sports Phys Ther. 2019;49(6):464\u201376.","journal-title":"J Orthop Sports Phys Ther"},{"key":"7649_CR5","doi-asserted-by":"crossref","unstructured":"Kalichman L, Carmeli E, Been E. The Association between Imaging Parameters of the Paraspinal Muscles, Spinal Degeneration, and Low Back Pain[J]. Biomed Res Int, 2017, 2017: 2562957.","DOI":"10.1155\/2017\/2562957"},{"key":"7649_CR6","doi-asserted-by":"publisher","first-page":"891088","DOI":"10.3389\/fendo.2022.891088","volume":"13","author":"Y Huang","year":"2022","unstructured":"Huang Y, Wang L, Luo B, et al. Associations of Lumber Disc Degeneration with paraspinal muscles myosteatosis in Discogenic Low Back Pain[J]. Front Endocrinol (Lausanne). 2022;13:891088.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"7649_CR7","doi-asserted-by":"publisher","first-page":"792819","DOI":"10.3389\/fendo.2022.792819","volume":"13","author":"Y Huang","year":"2022","unstructured":"Huang Y, Wang L, Zeng X, et al. Association of Paraspinal Muscle CSA and PDFF measurements with lumbar intervertebral disk degeneration in patients with chronic low back Pain[J]. Front Endocrinol (Lausanne). 2022;13:792819.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"3","key":"7649_CR8","doi-asserted-by":"publisher","first-page":"e1171","DOI":"10.1002\/jsp2.1171","volume":"4","author":"AM Noonan","year":"2021","unstructured":"Noonan AM, Brown SH. M. Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders[J]. JOR Spine. 2021;4(3):e1171.","journal-title":"JOR Spine"},{"key":"7649_CR9","doi-asserted-by":"crossref","unstructured":"Wang Zairan Z, Zijun H. Shiyuan, Advances in research on fat infiltration and lumbar intervertebral disc degeneration[J]. Front Endocrinol, 2022, 13.","DOI":"10.3389\/fendo.2022.1067373"},{"issue":"2","key":"7649_CR10","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/j.asjsur.2022.08.097","volume":"46","author":"B Cao","year":"2023","unstructured":"Cao B, Zuo Y, Xu Y, et al. Correlation between fat infiltration of paraspinal muscle and L4 degenerative lumbar spondylolisthesis in asymptomatic adults[J]. Asian J Surg. 2023;46(2):834\u201340.","journal-title":"Asian J Surg"},{"key":"7649_CR11","doi-asserted-by":"crossref","unstructured":"Cooley Jeffrey R, Jensen Tue S, Per K et al. Spinal degeneration is associated with lumbar multifidus morphology in secondary care patients with low back or leg pain[J]. Sci Rep, 2022, 12(1).","DOI":"10.1038\/s41598-022-18984-1"},{"issue":"3","key":"7649_CR12","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1007\/s00330-022-09140-4","volume":"33","author":"M Jung","year":"2023","unstructured":"Jung M, Rospleszcz S, Loffler MT, et al. Association of lumbar vertebral bone marrow and paraspinal muscle fat composition with intervertebral disc degeneration: 3T quantitative MRI findings from the population-based KORA study[J]. Eur Radiol. 2023;33(3):1501\u201312.","journal-title":"Eur Radiol"},{"key":"7649_CR13","doi-asserted-by":"publisher","first-page":"656487","DOI":"10.3389\/fneur.2021.656487","volume":"12","author":"F Mandelli","year":"2021","unstructured":"Mandelli F, Nuesch C, Zhang Y, et al. Assessing Fatty Infiltration of Paraspinal Muscles in patients with lumbar spinal stenosis: Goutallier classification and quantitative MRI Measurements[J]. Front Neurol. 2021;12:656487.","journal-title":"Front Neurol"},{"issue":"1","key":"7649_CR14","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1186\/s12891-022-05466-8","volume":"23","author":"L Shi","year":"2022","unstructured":"Shi L, Yan B, Jiao Y, et al. Correlation between the fatty infiltration of paraspinal muscles and disc degeneration and the underlying mechanism[J]. BMC Musculoskelet Disord. 2022;23(1):509.","journal-title":"BMC Musculoskelet Disord"},{"issue":"5","key":"7649_CR15","doi-asserted-by":"publisher","first-page":"e793","DOI":"10.3928\/01477447-20170531-05","volume":"40","author":"B Yu","year":"2017","unstructured":"Yu B, Jiang K, Li X, et al. Correlation of the features of the lumbar multifidus muscle with Facet Joint Osteoarthritis[J]. Orthopedics. 2017;40(5):e793\u2013800.","journal-title":"Orthopedics"},{"key":"7649_CR16","doi-asserted-by":"publisher","first-page":"563","DOI":"10.3389\/fendo.2018.00563","volume":"9","author":"N Sollmann","year":"2018","unstructured":"Sollmann N, Dieckmeyer M, Schlaeger S, et al. Associations between lumbar vertebral bone marrow and paraspinal muscle Fat Compositions-An Investigation by Chemical Shift Encoding-Based Water-Fat MRI[J]. Front Endocrinol (Lausanne). 2018;9:563.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"3","key":"7649_CR17","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1148\/radiol.2021204028","volume":"300","author":"R Marty Benjamin","year":"2021","unstructured":"Marty Benjamin R, Harmen B, Jean-Marc, et al. Water-Fat separation in MR Fingerprinting for quantitative monitoring of the skeletal muscle in Neuromuscular Disorders[J]. Radiology. 2021;300(3):652\u201360.","journal-title":"Radiology"},{"issue":"6","key":"7649_CR18","doi-asserted-by":"publisher","first-page":"421","DOI":"10.5455\/medarh.2019.73.421-424","volume":"73","author":"N Kos","year":"2019","unstructured":"Kos N, Gradisnik L, Velnar T. A brief review of the degenerative intervertebral disc Disease[J]. Med Arch. 2019;73(6):421\u20134.","journal-title":"Med Arch"},{"key":"7649_CR19","doi-asserted-by":"crossref","unstructured":"Silagi ES, Shapiro IM, Risbud MV. Glycosaminoglycan synthesis in the nucleus pulposus: Dysregulation and the pathogenesis of disc degeneration[J]. Matrix Biol, 2018, 71\u20132: 368\u2013379.","DOI":"10.1016\/j.matbio.2018.02.025"},{"issue":"2","key":"7649_CR20","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1080\/02688697.2020.1783434","volume":"35","author":"EE Ozcan-Eksi","year":"2021","unstructured":"Ozcan-Eksi EE, Eksi MS, Turgut VU, et al. Reciprocal relationship between multifidus and psoas at L4-L5 level in women with low back pain[J]. Br J Neurosurg. 2021;35(2):220\u20138.","journal-title":"Br J Neurosurg"},{"issue":"1","key":"7649_CR21","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1186\/s12891-019-2786-7","volume":"20","author":"C Faur","year":"2019","unstructured":"Faur C, Patrascu JM, Haragus H, et al. Correlation between multifidus fatty atrophy and lumbar disc degeneration in low back pain[J]. BMC Musculoskelet Disord. 2019;20(1):414.","journal-title":"BMC Musculoskelet Disord"},{"key":"7649_CR22","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.jocn.2021.10.005","volume":"94","author":"EE Ozcan-Eksi","year":"2021","unstructured":"Ozcan-Eksi EE, Turgut VU, Kucuksuleymanoglu D, et al. Obesity could be associated with poor paraspinal muscle quality at upper lumbar levels and degenerated spine at lower lumbar levels: is this a domino effect?[J]. J Clin Neurosci. 2021;94:120\u20137.","journal-title":"J Clin Neurosci"},{"key":"7649_CR23","doi-asserted-by":"publisher","first-page":"20200015","DOI":"10.2490\/prm.20200015","volume":"5","author":"T Miki","year":"2020","unstructured":"Miki T, Naoki F, Takashima H, et al. Associations between Paraspinal Muscle Morphology, disc degeneration, and clinical features in patients with lumbar spinal Stenosis[J]. Prog Rehabil Med. 2020;5:20200015.","journal-title":"Prog Rehabil Med"},{"issue":"2","key":"7649_CR24","doi-asserted-by":"publisher","first-page":"277","DOI":"10.3233\/BMR-140515","volume":"28","author":"G Wang","year":"2015","unstructured":"Wang G, Karki SB, Xu S, et al. Quantitative MRI and X-ray analysis of disc degeneration and paraspinal muscle changes in degenerative spondylolisthesis[J]. J Back Musculoskelet Rehabil. 2015;28(2):277\u201385.","journal-title":"J Back Musculoskelet Rehabil"},{"issue":"1","key":"7649_CR25","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1186\/s12891-021-04411-5","volume":"22","author":"G Xia","year":"2021","unstructured":"Xia G, Li X, Shang Y, et al. Correlation between severity of spinal stenosis and multifidus atrophy in degenerative lumbar spinal stenosis[J]. BMC Musculoskelet Disord. 2021;22(1):536.","journal-title":"BMC Musculoskelet Disord"},{"issue":"11","key":"7649_CR26","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.1016\/j.spinee.2014.04.022","volume":"14","author":"F Fardon David","year":"2014","unstructured":"Fardon David F, Williams Alan L, Dohring Edward J, et al. Lumbar disc nomenclature: version 2.0: recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology[J]. Spine J. 2014;14(11):2525\u201345.","journal-title":"Spine J"},{"issue":"5","key":"7649_CR27","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1097\/CORR.0000000000001153","volume":"478","author":"Koslosky","year":"2020","unstructured":"Koslosky, Ezekial. Gendelberg David Classification in brief: the Meyerding classification system of Spondylolisthesis[J]. Clin Orthop Relat Res. 2020;478(5):1125\u201330.","journal-title":"Clin Orthop Relat Res"},{"issue":"17","key":"7649_CR28","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1097\/00007632-200109010-00011","volume":"26","author":"CW Pfirrmann","year":"2001","unstructured":"Pfirrmann CW, Metzdorf A, Zanetti M, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration[J]. Spine (Phila Pa 1976). 2001;26(17):1873\u20138.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"4","key":"7649_CR29","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s002560050503","volume":"28","author":"D Weishaupt","year":"1999","unstructured":"Weishaupt D, Zanetti M, Boos N, et al. MR imaging and CT in osteoarthritis of the lumbar facet joints[J]. Skeletal Radiol. 1999;28(4):215\u20139.","journal-title":"Skeletal Radiol"},{"issue":"17","key":"7649_CR30","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1097\/BRS.0000000000002102","volume":"42","author":"J Hancock Mark","year":"2017","unstructured":"Hancock Mark J, Per K, Peter K, et al. Is the number of different MRI findings more strongly Associated with Low Back Pain Than single MRI findings?[J]. Spine (Phila Pa 1976). 2017;42(17):1283\u20138.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"10","key":"7649_CR31","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1016\/j.spinee.2020.04.007","volume":"20","author":"S Stevens","year":"2020","unstructured":"Stevens S, Agten A, Timmermans A, et al. Unilateral changes of the multifidus in persons with lumbar disc herniation: a systematic review and meta-analysis[J]. Spine J. 2020;20(10):1573\u201385.","journal-title":"Spine J"},{"issue":"7","key":"7649_CR32","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1016\/j.spinee.2015.03.039","volume":"15","author":"AJ Teichtahl","year":"2015","unstructured":"Teichtahl AJ, Urquhart DM, Wang Y, et al. Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults[J]. Spine J. 2015;15(7):1593\u2013601.","journal-title":"Spine J"},{"key":"7649_CR33","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/1741-7015-5-2","volume":"5","author":"P Kjaer","year":"2007","unstructured":"Kjaer P, Bendix T, Sorensen JS, et al. Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?[J]. BMC Med. 2007;5:2.","journal-title":"BMC Med"},{"issue":"3","key":"7649_CR34","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1148\/radiol.2403050820","volume":"240","author":"B Mengiardi","year":"2006","unstructured":"Mengiardi B, Schmid MR, Boos N, et al. Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy[J]. Radiology. 2006;240(3):786\u201392.","journal-title":"Radiology"},{"issue":"1","key":"7649_CR35","doi-asserted-by":"publisher","first-page":"6739","DOI":"10.1038\/s41598-020-63784-0","volume":"10","author":"Y Aoki","year":"2020","unstructured":"Aoki Y, Takahashi H, Nakajima A, et al. Prevalence of lumbar spondylolysis and spondylolisthesis in patients with degenerative spinal disease[J]. Sci Rep. 2020;10(1):6739.","journal-title":"Sci Rep"},{"issue":"2","key":"7649_CR36","doi-asserted-by":"publisher","first-page":"190","DOI":"10.3171\/2020.6.SPINE20238","volume":"34","author":"PG Duan","year":"2020","unstructured":"Duan PG, Mummaneni PV, Guinn JMV, et al. Is the Goutallier grade of multifidus fat infiltration associated with adjacent-segment degeneration after lumbar spinal fusion?[J]. J Neurosurg Spine. 2020;34(2):190\u20135.","journal-title":"J Neurosurg Spine"},{"issue":"6","key":"7649_CR37","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/j.jos.2019.08.021","volume":"24","author":"T Nakamae","year":"2019","unstructured":"Nakamae T, Nakanishi K, Kamei N, et al. The correlation between sagittal spinopelvic alignment and degree of lumbar degenerative spondylolisthesis[J]. J Orthop Sci. 2019;24(6):969\u201373.","journal-title":"J Orthop Sci"},{"issue":"13","key":"7649_CR38","doi-asserted-by":"publisher","first-page":"2669","DOI":"10.1113\/JP279595","volume":"598","author":"K Biltz Nicole","year":"2020","unstructured":"Biltz Nicole K, Collins Kelsey H, Shen Karen C, et al. Infiltration of intramuscular adipose tissue impairs skeletal muscle contraction[J]. J Physiol. 2020;598(13):2669\u201383.","journal-title":"J Physiol"},{"issue":"2","key":"7649_CR39","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1152\/japplphysiol.00426.2019","volume":"128","author":"TL Chambers","year":"2020","unstructured":"Chambers TL, Burnett TR, Raue U, et al. Skeletal muscle size, function, and adiposity with lifelong aerobic exercise[J]. J Appl Physiol (1985). 2020;128(2):368\u201378.","journal-title":"J Appl Physiol (1985)"},{"issue":"5","key":"7649_CR40","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1097\/CORR.0000000000001153","volume":"478","author":"E Koslosky","year":"2020","unstructured":"Koslosky E, Gendelberg D. Classification in brief: the Meyerding classification system of Spondylolisthesis[J]. Clin Orthop Relat Res. 2020;478(5):1125\u201330.","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"7649_CR41","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1007\/s00256-021-03953-y","volume":"51","author":"YQ Zuo","year":"2022","unstructured":"Zuo YQ, Gao ZH, Wang Z, et al. Utility of multidetector computed tomography quantitative measurements in identifying Sarcopenia: a propensity score matched study[J]. Skeletal Radiol. 2022;51(6):1303\u201312.","journal-title":"Skeletal Radiol"},{"issue":"8","key":"7649_CR42","first-page":"571","volume":"52","author":"X Guo","year":"2014","unstructured":"Guo X, Zhang X, Ding W, et al. [Imaging study of paravertebral muscle degeneration in degenerative lumbar instability][J]. Zhonghua Wai Ke Za Zhi. 2014;52(8):571\u20135.","journal-title":"Zhonghua Wai Ke Za Zhi"},{"issue":"1","key":"7649_CR43","doi-asserted-by":"publisher","first-page":"4161","DOI":"10.1038\/s41598-023-31224-4","volume":"13","author":"Y He","year":"2023","unstructured":"He Y, Wang W, Zhou H, et al. Imaging analysis and predictive nomogram construction for degenerative lumbar spondylolisthesis with severe clinical symptom based on propensity score matching[J]. Sci Rep. 2023;13(1):4161.","journal-title":"Sci Rep"},{"issue":"5","key":"7649_CR44","doi-asserted-by":"publisher","first-page":"353","DOI":"10.3109\/07853898909149220","volume":"21","author":"H Kalimo","year":"1989","unstructured":"Kalimo H, Rantanen J, Viljanen T, et al. Lumbar muscles: structure and function[J]. Ann Med. 1989;21(5):353\u20139.","journal-title":"Ann Med"},{"issue":"4","key":"7649_CR45","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/0268-0033(86)90146-4","volume":"1","author":"JE Macintosh","year":"1986","unstructured":"Macintosh JE, Valencia F, Bogduk N, et al. The morphology of the human lumbar multifidus[J]. Clin Biomech (Bristol Avon). 1986;1(4):196\u2013204.","journal-title":"Clin Biomech (Bristol Avon)"},{"key":"7649_CR46","doi-asserted-by":"publisher","first-page":"e1069","DOI":"10.1016\/j.wneu.2018.10.229","volume":"122","author":"EE Ozcan-Eksi","year":"2019","unstructured":"Ozcan-Eksi EE, Eksi MS, Akcal MA. Severe lumbar intervertebral disc degeneration is Associated with Modic changes and fatty infiltration in the paraspinal muscles at all lumbar levels, except for L1-L2: a cross-sectional analysis of 50 symptomatic women and 50 age-matched symptomatic Men[J]. World Neurosurg. 2019;122:e1069\u201377.","journal-title":"World Neurosurg"},{"issue":"7","key":"7649_CR47","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1007\/s00256-018-2880-1","volume":"47","author":"J Urrutia","year":"2018","unstructured":"Urrutia J, Besa P, Lobos D, et al. Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients[J]. Skeletal Radiol. 2018;47(7):955\u201361.","journal-title":"Skeletal Radiol"},{"issue":"14","key":"7649_CR48","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1097\/BRS.0000000000003035","volume":"44","author":"JF Bailey","year":"2019","unstructured":"Sions JM, Elliott JM, Pohlig RT, et al. Trunk muscle characteristics of the Multifidi, Erector Spinae, Psoas, and Quadratus Lumborum in older adults with and without chronic low back Pain[J]. J Orthop Sports Phys Ther. 2017;47(3):173\u20139.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"4","key":"7649_CR49","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1097\/00002517-199212000-00001","volume":"5","author":"MM Panjabi","year":"1992","unstructured":"Bailey JF, Fields AJ, Ballatori A, et al. The relationship between Endplate Pathology and patient-reported symptoms for chronic low back Pain depends on lumbar paraspinal muscle Quality[J]. Spine (Phila Pa 1976). 2019;44(14):1010\u20137.","journal-title":"J Spinal Disord"},{"issue":"3","key":"7649_CR50","doi-asserted-by":"publisher","first-page":"173","DOI":"10.2519\/jospt.2017.7002","volume":"47","author":"JM Sions","year":"2017","unstructured":"Panjabi MM. The stabilizing system of the spine. Part I. function, dysfunction, adaptation, and enhancement[J]. J Spinal Disord. 1992;5(4):383\u20139. discussion 397.","journal-title":"J Orthop Sports Phys Ther"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-024-07649-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-024-07649-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-024-07649-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T04:02:15Z","timestamp":1721102535000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-024-07649-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,16]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["7649"],"URL":"https:\/\/doi.org\/10.1186\/s12891-024-07649-x","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,16]]},"assertion":[{"value":"18 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of the First Affiliated Hospital of Kunming Medical University and was conducted in accordance with the 1964 Declaration of Helsinki. Verbal informed consent was obtained from all patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"549"}}