Evidence map›Paper›PMID 41477594›Full record

ArticleNorth American Spine Society journal2025

Development and reliability of a systematic method to evaluate lumbar paraspinal muscle size and quality in computed tomography images.

Cristiane R Carlesso, Jaclyn M Sions, William J Anderst, Charity G Patterson, Rafaela M Barbosa, Luiza P Weissmann, Tom Gale, Michael J Schneider, Sara R Piva

Abstract read
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In one paragraph

Article in North American Spine Society journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Cristiane R CarlessoDepartment of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Dr., Salt Lake City, UT 84108, United States.
Jaclyn M SionsDepartment of Physical Therapy, University of Delaware, STAR Health Sciences Complex, 540 S College Ave, Newark, DE 19713, United States.
William J AnderstDepartment of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15206, United States.
Charity G PattersonDepartment of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, United States.
Rafaela M BarbosaDepartment of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, United States.
Luiza P WeissmannDepartment of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, United States.
Tom GaleDepartment of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15206, United States.
Michael J SchneiderDepartment of Community Health Services & Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, United States.
Sara R PivaDepartment of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Lumbar paraspinal muscles (LPMs) are critical for spinal stability, and their morphological alterations are associated with chronic low back pain (cLBP). Computed tomography (CT) offers a feasible alternative to magnetic resonance imaging for assessing LPM morphology; however, its broader use has been hindered by inconsistent measurement methods and limited reliability data. This study aimed to describe a systematic CT-based method for evaluating LPM cross-sectional area (CSA) and attenuation (MA) in adults with cLBP and to determine its intra and inter-examiner procedural reliability. Methods: High-resolution CT images were used to analyze bilateral LPMs: erector spinae (L1-L5), multifidi (L1-S1), psoas (L3), and quadratus lumborum (L3). Two trained examiners independently performed image selection and analysis, blinded to subject identity and prior results. Procedural reliability was quantified using intraclass correlation coefficients (ICC Results: Thirty-six participants (40% female; age 48±15 years; BMI 27.2±4.3 kg/m²) with moderate disability were included. Intraexaminer procedural reliability was excellent for CSA of the erector spinae, psoas, and quadratus lumborum (ICC point estimates >0.916, >0.959, and >0.962, respectively); and good to excellent for multifidi CSA (ICC point estimates: 0.770-0.916), with greater variability at L1 and L2. Inter-examiner procedural reliability was excellent for CSA of the erector spinae, psoas, and quadratum lumborum (ICC point estimates >0.916, >0.946, and >0.941, respectively); and moderate to excellent for multifidi CSA (ICC point estimates: 0.593-0.945), with lower reliability at upper lumbar levels. Intra and inter-examiner procedural reliability for MA was excellent across all LPMs. Conclusions: The presented CT-based protocol provides a standardized and reproducible method for assessing LPM CSA and MA in adults with cLBP. Demonstrated high procedural reliability-including image selection and analysis-supports its use for consistent evaluation of LPM morphology in both clinical and research contexts, particularly where muscle degeneration complicates image-based assessment.

Indexed as

Computed tomographyLow back painMuscle imaging analysisParaspinal musclesReliabilityReproducibility of results

Identifiers

PMID41477594
PMCPMC12753261

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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.