{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:07:26Z","timestamp":1779959246737,"version":"3.53.1"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The thoracolumbar fascia (TLF) has been implicated in low back pain, but imaging-based characterization in degenerative lumbar disorders, particularly in surgical cohorts, remains limited. To describe MRI-derived and US-derived TLF thickness estimates in a heterogeneous degenerative lumbar surgical cohort and explore preliminary imaging patterns and associations with selected clinical variables. Materials and Methods: In this prospective single-center cohort, adults scheduled for elective lumbar surgery underwent preoperative US (short- and long-axis at L3) and review of routine lumbar MRI (axial and sagittal T1-weighted measurements at L3) using standardized protocols. Twenty-six patients were included (15 with lumbar spinal stenosis, five with lumbar disc herniation, four with spondylolisthesis, and two with scoliosis). Disability was assessed using the Oswestry Disability Index (ODI). Exploratory subgroup comparisons, correlation analyses, and Bland\u2013Altman agreement analysis were used to examine subgroup patterns, patient\u2013factor associations, and MRI\u2013US agreement. Results: Interpretable data were available for 19 axial MRI, 18 sagittal MRI, 19 short-axis US, 15 long-axis US, and 19 ODI assessments; paired MRI\u2013US measurements were available in 11 cases for sagittal\/long-axis analysis and 12 for axial\/short-axis analysis. Mean TLF thickness was 0.89 \u00b1 0.33 mm on axial MRI, 1.16 \u00b1 0.48 mm on sagittal MRI, 2.53 \u00b1 1.44 mm on short-axis US, and 2.49 \u00b1 1.14 mm on long-axis US. Exploratory subgroup analyses showed a between-diagnosis difference only for axial-MRI-derived TLF thickness (p = 0.007), with lower thickness in disc herniation than in stenosis (p = 0.008), while sagittal MRI and US thickness measures did not differ between groups (p \u2265 0.301). ODI was not consistently associated with TLF thickness on MRI or US. Conclusions: In this exploratory surgical cohort, US-derived TLF thickness values were higher than those previously reported in the literature, suggesting possible fascial alteration in degenerative lumbar disease. However, TLF thickness was not consistently associated with disability, and MRI- and US-derived measurements should be interpreted as modality-specific estimates rather than interchangeable values. Given the small heterogeneous cohort and measurement constraints, these findings are descriptive and preliminary, but they provide an imaging framework to guide future standardized studies.<\/jats:p>","DOI":"10.3390\/medicina62061045","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T08:00:36Z","timestamp":1779955236000},"page":"1045","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MRI and Ultrasound of the Thoracolumbar Fascia in the Setting of Degenerative Spinal Diseases"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8707-0463","authenticated-orcid":false,"given":"Noa","family":"Martonovich","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Hillel Yaffe Medical Center, Hadera 3820302, Israel"},{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"De Luca","sequence":"additional","affiliation":[{"name":"Institute of Human Anatomy, Department of Neuroscience, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4372-7889","authenticated-orcid":false,"given":"Caterina","family":"Fede","sequence":"additional","affiliation":[{"name":"Institute of Human Anatomy, Department of Neuroscience, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8823-448X","authenticated-orcid":false,"given":"Andrea","family":"Angelini","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-9882","authenticated-orcid":false,"given":"Pietro","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Behrbalk","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hillel Yaffe Medical Center, Hadera 3820302, Israel"},{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8767-4555","authenticated-orcid":false,"given":"Carla","family":"Stecco","sequence":"additional","affiliation":[{"name":"Institute of Human Anatomy, Department of Neuroscience, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-6549","authenticated-orcid":false,"given":"Carmelo","family":"Pirri","sequence":"additional","affiliation":[{"name":"Institute of Human Anatomy, Department of Neuroscience, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","article-title":"What low back pain is and why we need to pay 397 attention","volume":"391","author":"Hartvigsen","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of 400 Disease Study 2021","volume":"5","author":"Ferreira","year":"2023","journal-title":"Lancet Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E1386","DOI":"10.1503\/cmaj.170527","article-title":"Diagnosis and management of low-back pain in primary care","volume":"189","author":"Traeger","year":"2017","journal-title":"CMAJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1056\/NEJM200102013440508","article-title":"Low Back Pain","volume":"344","author":"Deyo","year":"2001","journal-title":"N. 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