To analyze the correlation between the cross-sectional area (CSA) and density of lumbar core muscles and residual chronic low back pain (rCLBP) after Posterior Lumbar Interbody Fusion (PLIF).
Approach:
Study Design: Retrospective analysis of patients who underwent PLIF surgery, stratified into rCLBP and non-pain control groups based on postoperative pain status.
Measurements: Preoperative lumbar CT measured CSA and mean density of psoas major, quadratus lumborum, and paraspinal muscles, along with confounding factors.
Statistical Analysis: Logistic regression analysis was used to identify independent risk factors for rCLBP.
Key Findings:
Lower CSA of the psoas major and paraspinal muscles were independently associated with rCLBP (P < 0.05).
Lower mean HU of the quadratus lumborum was also independently associated with rCLBP (P < 0.05).
Longer disease duration and larger Cobb angle were associated with rCLBP but were not statistically significant in multivariate analysis.
Interpretation:
Muscle density may serve as a sensitive imaging biomarker for quadratus lumborum.
Limitations:
Causality cannot be inferred due to the retrospective design.
Postoperative muscle recovery was not assessed with preoperative CT-only data.
Conclusion:
Preoperative lumbar muscle morphology, specifically CSA and density, is associated with the development of rCLBP following PLIF.
