ArticleJournal of spine surgery (Hong Kong)2025
The effect of baseline spinal magnetic resonance imaging features on restorative neurostimulation efficacy in patients with chronic low back pain.
Article in Journal of spine surgery (Hong Kong), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Response to Tieppo Francio V, Russo M, Gilligan C. Letter to the Editor Re: "Lumbar multifidus muscle morphology on MRI after restorative neurostimulation for chronic low back pain: a single centre case series using the Goutallier classification" by Whittle et al. (Eur Spine J [2026]: DOI: 10.1007/s00586-026-09863-8). Eur Spine J. 2026 May 30. doi: 10.1007/s00586-026-10050-y. VT Francio et al.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 · 2026Review
- Lumbar multifidus muscle morphology on MRI after restorative neurostimulation for chronic low back pain: a single centre case series using the Goutallier classification.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
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Background: Multifidus muscle may be reflexively inhibited by painful co-existing structural degenerative features, affecting spinal loading and control in patients with chronic low back pain (cLBP). This study aimed to investigate the relationship between magnetic resonance imaging (MRI) features of lumbar spine degeneration and their influence on clinical outcomes of multifidi neurostimulation for cLBP. Methods: This is a secondary analysis of a Food and Drug Administration (FDA) randomized controlled trial testing the efficacy of an implantable neurostimulator targeting the L2 dorsal rami medial branch nerves innervating the deep multifidi in 204 subjects. Degenerative anatomical features of the lumbar discs, vertebrae, facets, and paraspinal muscles were graded using standardized criteria. Patient-reported outcomes (PROs), including visual analog scale (VAS), Oswestry Disability Index (ODI), and the five-level version of the EuroQol five-dimensional descriptive system (EQ-5D-5L), were collected at baseline, 12, and 24 months. Mixed-design analysis of variance (ANOVA) and post hoc pairwise Results: Included 204 subjects [110 females, 94 males; age: mean ± standard deviation (SD) =47±9 years; body mass index (BMI): mean ± SD =28±4 kg/m Conclusions: Results indicate that, in a population of cLBP patients, existing lumbar spinal degeneration did not influence the effect of the neurostimulation therapy on PROs. Thus, the presence of mild and moderate lumbar spinal degeneration does not appear to be a contraindication for implantable multifidus neurostimulation, including patients with grade I spondylolisthesis.
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