ArticleSpine2015
The Rapid and Progressive Degeneration of the Cervical Multifidus in Whiplash: An MRI Study of Fatty Infiltration.
Article in Spine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 3 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Muscle fat infiltration and its relation with pain intensity, disability, and cervical curvature in individuals with nonspecific neck pain: A systematic review study.PM & R : the journal of injury, function, and rehabilitation · 2026Pooled it
- Massage for neck pain.The Cochrane database of systematic reviews · 2024Pooled it
- Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review.BMC musculoskeletal disorders · 2018Pooled it
- Effect of instrument-assisted soft tissue mobilization combined with exercise therapy on pain and muscle endurance in patients with chronic neck pain: a randomized controlled study.The Journal of manual & manipulative therapy · 2024Trial
- Trial
- Efficacy of Neck-Specific Exercise With Internet Support Versus Neck-Specific Exercise at a Physiotherapy Clinic in Chronic Whiplash-Associated Disorders: Multicenter Randomized Controlled Noninferiority Trial.Journal of medical Internet research · 2023Trial
- Neck-specific exercises with internet-based support compared to neck-specific exercises at a physiotherapy clinic for chronic whiplash-associated disorders: study protocol of a randomized controlled multicentre trial.BMC musculoskeletal disorders · 2017Trial
- Association of paraspinal fat infiltration with postoperative clinical outcomes in older cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion.BMC geriatrics · 2026Article
- A Magnetic Resonance Imaging (MRI) Investigation of Cervical Spine Muscle Characteristics After Concussion: Identifying Return-to-Play Clearance and Subsequent Injury Prognosis.Journal of child neurology · 2026Article
- Intratissue percutaneous electrolysis and deep dry needling compared to a standard physiotherapy protocol in the treatment of whiplash syndrome: study protocol for a randomized controlled trial.Frontiers in rehabilitation sciences · 2025Article
- Muscle fat infiltration: a narrative review of the magnetic resonance (MR)-based evaluation methods and their clinical applications.Quantitative imaging in medicine and surgery · 2024Review
- Whether the potential degree of cervical instability and cervical muscle degeneration in patients with cervical spondylosis radicular affect the efficacy of cervical traction.Scientific reports · 2024Article
- Identifying and exploring the favorable factors that help to slow the progression of disease in patients with mild cervical spondylotic myelopathy.Scientific reports · 2024Article
- Reduced Cervical Muscle Fat Infiltrate Is Associated with Self-Reported Recovery from Chronic Idiopathic Neck Pain Over Six Months: A Magnetic Resonance Imaging Longitudinal Cohort Study.Journal of clinical medicine · 2024Article
- Results of neck-specific exercise for altered postural sway in individuals with chronic whiplash-associated disorders: a longitudinal case-control study.Scientific reports · 2024Article
- Morphological Changes of Deep Extensor Neck Muscles in Relation to the Maximum Level of Cord Compression and Canal Compromise in Patients With Degenerative Cervical Myelopathy.Global spine journal · 2024Article
- Artificial Intelligence in Spine and Paraspinal Muscle Analysis.Advances in experimental medicine and biology · 2024Review
- Fatty infiltration of the cervical multifidus musculature and its clinical correlation to cervical spondylosis.BMC musculoskeletal disorders · 2023Article
- Article
- Biopsychosocial sequelae and recovery trajectories from whiplash injury following a motor vehicle collision.The spine journal : official journal of the North American Spine Society · 2023Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
designSingle-center prospective longitudinal study.
objectiveTo study the (1) temporal development of muscle fatty infiltrates (MFI) in the cervical multifidi after whiplash, (2) differences in multifidi MFI between those who recover or report milder pain-related disability and those who report moderate/severe symptoms at 3 months, and (3) predictive value of multifidi MFI outcomes. SUMMARY OF BACKGROUND DATA: The temporal development of MFI on conventional magnetic resonance image has been shown to be associated with specific aspects of pain and psychological factors. The replication of such findings has yet to be explored longitudinally.
methodsThirty-six subjects with whiplash injury were enrolled at less than 1 week postinjury and classified at 3 months using percentage scores on the Neck Disability Index as recovered/mild (0%-28%) or severe (≥30%). A fat/water magnetic resonance imaging measure, patient self-report of pain-related disability, and post-traumatic stress disorder were collected at less than 1 week, 2 weeks, and 3 months postinjury. The effects of time and group (per Neck Disability Index) and the interaction of time by group on MFI were determined. Receiver operating characteristic curve analysis was used to determine a cut-point for MFI at 2 weeks to predict outcome at 3 months.
resultsThere was no difference in MFI across groups at enrolment. MFI values were significantly higher in the severe group than those in the recovered/mild group at 2 weeks and 3 months. The receiver operating characteristic curve analysis indicated that MFI levels of 20.5% or above resulted in a sensitivity of 87.5% and a specificity of 92.9% for predicting outcome at 3 months.
conclusionConsistent with previous evidence, muscle degeneration occurs soon after injury but only in those patients with poor functional recovery. This study provides further evidence that (1) multifidi MFI occur in tandem with known predictive risk factors (older age, pain-related disability, and post-traumatic stress disorder) and (2) routine imaging protocols may need to be reconsidered in the vast majority of patients after whiplash. LEVEL OF EVIDENCE: 3.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.