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No significant differences in CSA were observed between groups (all <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). However, PDFF values were significantly higher in the LDH group for all muscles compared to controls (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). After adjustment, the PDFF differences in MF<jats:sub>L4\/5<\/jats:sub>, ES<jats:sub>L4\/5<\/jats:sub>, PM<jats:sub>L3\/4<\/jats:sub>, and PM<jats:sub>L4\/5<\/jats:sub> remained statistically significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Although bilateral muscle asymmetry was observed in several muscles, these differences were no longer significant after adjustment (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). No significant differences in VBFF, LL, or SS were found (all <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>LDH patients exhibit increased fat infiltration in the MF, ES, PM, and GM compared to controls, suggesting a potential association between pelvic and paraspinal muscle degeneration and LDH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Critical relevance statement<\/jats:title>\n            <jats:p>The MRI q-Dixon technique effectively and noninvasively detects early degeneration of the paraspinal muscles and GM, indicating their potential association with LDH and enabling more targeted rehabilitation strategies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>Spine and muscle changes affect LDH, but their relationship remains unclear.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Fat infiltration is more sensitive than CSA for detecting muscle degeneration.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>LDH patients exhibit greater paraspinal muscle and GM degeneration.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s13244-025-02064-9","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T11:59:33Z","timestamp":1755172773000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Paraspinal muscles and gluteus medius fat infiltration are both associated with lumbar disc herniation"],"prefix":"10.1186","volume":"16","author":[{"given":"Jianping","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhua","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3814-7126","authenticated-orcid":false,"given":"Dingbo","family":"Shu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"2064_CR1","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 (2022) Association of paraspinal muscle CSA and PDFF measurements with lumbar intervertebral disk degeneration in patients with chronic low back pain. 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