SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
Is fatty infiltration in paraspinal muscles reversible with exercise in people with low back pain? A systematic review.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 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
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Systematic Review of Paraspinal Muscle Changes in Lumbar Spondylolisthesis: MRI and CT Insights.Orthopaedic surgery · 2026Pooled it
- Association of paraspinal muscle morphology or composition with sagittal spinopelvic alignment: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Structural changes of the multifidus in animal models of intervertebral disk degeneration: a systematic review.Frontiers in surgery · 2024Pooled it
- Effect of core stabilization exercises on lumbar multifidus morphology and functional outcomes in chronic non-specific low back pain: a randomized controlled trial.BMC musculoskeletal disorders · 2025Trial
- Aquatic exercise versus standard care on paraspinal muscle morphology and function in chronic low back pain patients: a randomized controlled trial.Scientific reports · 2025Trial
- Trial
- Spinal Muscle Health in Chronic Low Back Pain: An Integrated Narrative Review of Muscle Quality, Function, and Clinical Implications.Bioengineering (Basel, Switzerland) · 2026Review
- Quantitative MRI of core muscles at different activity levels: muscle-specific metrics and composite core fat fraction and lean-volume scores.Skeletal radiology · 2026Article
- Gluteal Muscle Degeneration Is Associated with Compensation Failure in Age-Related Spinopelvic Malalignment: A Cross-Sectional Study.Spine surgery and related research · 2026Article
- Higher lumbodorsal epimuscular fat associated with recurrent low back pain: an exploratory secondary analysis of cross-sectional MRI data with 1-year follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- The effect of a multimodal exercise program on paraspinal muscle morphology and clinical outcomes in chronic low back pain.Isokinetics and exercise science · 2026Article
- Feasibility and Reliability of an Automated Muscle Segmentation Pipeline Linking Thoracic Supine Kyphosis and Trunk Muscle-Fat% on CT.Tomography (Ann Arbor, Mich.) · 2026Article
- Effects of aquatic therapy vs. standard care on gluteal muscle morphology and function in individuals with chronic low back pain: a randomized controlled trial.BMC sports science, medicine & rehabilitation · 2026Article
- Article
- Quantitative MRI assessment of paraspinal muscles and the psoas: associations with low back pain.Quantitative imaging in medicine and surgery · 2026Article
- Active and passive physical therapy in patients with chronic low-back pain: a level I Bayesian network meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Article
- Evaluation and analysis of risk factors for fractured vertebral recompression post-percutaneous kyphoplasty: a retrospective cohort study based on logistic regression analysis.BMC musculoskeletal disorders · 2025Article
- Effects of Active Spinal Orthosis on Fatty Infiltration in Paraspinal Muscles in Kyphotic Women with Osteoporotic Vertebral Fracture-Sub-Analysis of a Randomized Controlled Trial.Healthcare (Basel, Switzerland) · 2025Article
- Supine Bridge Exercise for Low Back Pain: A Fascial Approach for Movement Impairment Syndromes (Part II).Cureus · 2025Review
- Lumbar Muscle Fatty Infiltration and Atrophy in Patients with Low Back Pain and Degenerative Spinal Pathologies: A CT Imaging Study.Journal of clinical medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
Abstract
purposeIncreased fatty infiltration in paraspinal muscles has been recognized as a feature of muscle quality loss in people with Low Back Pain (LBP) and is highly associated with the severity of LBP and dysfunction. Reducing fatty infiltration has been recognized as a rehabilitation aim. An earlier systematic review published in 2014 revealed conflicting evidence for the reversibility of paraspinal muscle quality by means of exercise and no updates have been published since. A new systematic literature search is warranted.
methodPubmed, CINAHL and Embase were searched from inception to July 2022. Randomized, non-randomized controlled trials (RCT and non-RCT) and single-arm trials were included if they reported the effect of exercise on paraspinal fatty infiltration in people with LBP. Effect sizes and statistical power were calculated for (1) exercise versus control, and (2) pre-post exercise changes. Available data from the RCTs were pooled via meta-analysis when appropriate. Otherwise, data were synthesized qualitatively.
resultsTwo RCTs, one non-RCT and three single-arm trials met the selection criteria. Data were not pooled due to substantial clinical heterogeneity. Effect sizes from the RCTs revealed no significant difference for exercise versus control. One single-arm trial with high risk of bias demonstrated a significant pre-post difference with moderate effect size, but only at one (T12-L1) of the investigated levels.
conclusionModerate quality evidence is available that paraspinal fatty infiltration is not reversible with exercise in people with LBP. More larger RCT's are needed to draw firmer conclusions.
Indexed as
Identifiers
What OpenQuestion holds
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.