ArticleThe spine journal : official journal of the North American Spine Society2024
Investigating the associations between lumbar paraspinal muscle health and age, BMI, sex, physical activity, and back pain using an automated computer-vision model: a UK Biobank study.
Article in The spine journal : official journal of the North American Spine Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preoperative paraspinal muscle fatty infiltration and prognosis after lumbar discectomy for disc herniation: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2026Pooled it
- Associations between trunk mobility, pain, and quality of life in individuals with chronic low back pain treated with different therapeutic protocols: Potential clinical parameters.Journal of back and musculoskeletal rehabilitation · 2026Trial
- Aquatic exercise versus standard care on paraspinal muscle morphology and function in chronic low back pain patients: a randomized controlled trial.Scientific reports · 2025Trial
- Spinal Muscle Health in Chronic Low Back Pain: An Integrated Narrative Review of Muscle Quality, Function, and Clinical Implications.Bioengineering (Basel, Switzerland) · 2026Review
- Fat matters: paraspinal muscle quality is associated with electromyographic fatigability and endurance in lumbar spinal stenosis.North American Spine Society journal · 2026Article
- Detecting scoliosis at scale using automated Cobb angle analysis in the UK Biobank.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
- Association Between Body Composition, Muscle-to-Weight Ratio, and Functional Disability in Patients with Chronic Non-Specific Low Back Pain: A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Quantitative MRI of core muscles at different activity levels: muscle-specific metrics and composite core fat fraction and lean-volume scores.Skeletal radiology · 2026Article
- Patterns of Muscle Health in Single- and Multi-Site Chronic Pain: A UK Biobank Normative Modeling Study.medRxiv : the preprint server for health sciences · 2026Article
- Automated lumbar muscles segmentation with segment anything model for adult degenerative scoliosis.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
- Magnetic Resonance Imaging Segmentation of Soft Tissue in the Diagnosis of Chronic Low Back Pain: A Scoping Review.Diagnostics (Basel, Switzerland) · 2026Review
- The effect of a multimodal exercise program on paraspinal muscle morphology and clinical outcomes in chronic low back pain.Isokinetics and exercise science · 2026Article
- Deep learning-based assessment of paraspinal muscle degeneration and its relationships to muscle function and disability outcomes in chronic low back pain: a prospective study.European radiology · 2026Article
- Chronicity and physical activity levels independently associate with spatial patterns of multifidus fat infiltration in chronic low back pain patients.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
- Radiomics and Back Pain.Global spine journal · 2026Review
- Automated deep-learning quantification of intramuscular fat in lumbar spine muscles on Dixon MRI: validation and normative reference values from 173 healthy adults.BMC medical imaging · 2026Article
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- Spatial patterns of fat within the deep multifidus as a biomarker for chronic low back pain.The spine journal : official journal of the North American Spine Society · 2026Observational
- Changes of water and muscle content in lumbar paraspinal muscle degeneration and gender differences during aging using dual-energy CT.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 · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
background contextThe role of lumbar paraspinal muscle health in back pain (BP) is not straightforward. Challenges in this field have included the lack of tools and large, heterogenous datasets to interrogate the association between muscle health and BP. Computer-vision models have been transformative in this space, enabling the automated quantification of muscle health and the processing of large datasets. PURPOSE: To investigate the associations between lumbar paraspinal muscle health and age, sex, BMI, physical activity, and BP in a large, heterogenous dataset using an automated computer-vision model.
designCross-sectional study. PATIENT SAMPLE: Participants from the UK Biobank with abdominal Dixon fat-water MRI (N=9,564) were included (41.8% women, mean [SD] age: 63.5 [7.6] years, BMI: 26.4 [4.1] kg/m OUTCOME MEASURES: Intramuscular fat (IMF) and average cross-sectional area (aCSA) were automatically derived using a computer-vision model for the left and right lumbar multifidus (LM), erector spinae (ES), and psoas major (PM) from the L1 to L5 vertebral levels.
methodsTwo-tailed partial Pearson correlations were generated for each muscle to assess the relationships between the muscle measures (IMF and aCSA) and age (controlling for BMI, sex, and physical activity), BMI (controlling for age, sex, and physical activity), and physical activity (controlling for age, sex, and BMI). One-way ANCOVA was used to identify sex differences in IMF and aCSA for each muscle while controlling for age, BMI, and physical activity. Similarly, one-way ANCOVA was used to identify between-group differences (no pain, acute BP, and chronic BP) for each muscle and along the superior-inferior expanse of the lumbar spine while controlling for age, BMI, sex, and physical activity (α=0.05).
resultsFemales had higher IMF (LM mean difference [MD]=11.1%, ES MD=10.2%, PM MD=0.3%, p<.001) and lower aCSA (LM MD=47.6 mm
conclusionsParaspinal muscle health is associated with age, BMI, sex, and physical activity with the exception of the association between LM aCSA and age and physical activity. People with BP (chronic>acute) have higher IMF and lower aCSA than people reporting no pain. The differences were not localized but broadly distributed across the lumbar spine. When interpreting measures of paraspinal muscle health in the research or clinical setting, the associations with age, BMI, sex, and physical activity should be considered.
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