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dc.contributor.authorStorheim, Kjersti
dc.contributor.authorBerg, Linda
dc.contributor.authorHellum, Christian
dc.contributor.authorGjertsen, Øivind
dc.contributor.authorNeckelmann, Gesche
dc.contributor.authorEspeland, Ansgar
dc.contributor.authorKeller, Anne
dc.date.accessioned2018-05-02T09:02:29Z
dc.date.available2018-05-02T09:02:29Z
dc.date.issued2017-04-14
dc.description.abstractBackground: Evidence is lacking on whether fat infiltration in the multifidus muscles affects outcomes after total disc replacement (TDR) surgery and if it develops after surgery. The aims of this study were 1) to investigate whether pre-treatment multifidus muscle fat infiltration predicts outcome 2 years after treatment with TDR surgery or multidisciplinary rehabilitation, and 2) to compare changes in multifidus muscle fat infiltration from pre-treatment to 2-year follow-up between the two treatment groups. <br> <br> Methods: The study is secondary analysis of data from a trial with 2-year follow-up of patients with chronic low back pain (LBP) and degenerative disc randomized to TDR surgery or multidisciplinary rehabilitation. We analyzed (aim 1) patients with both magnetic resonance imaging (MRI) at pre-treatment and valid data on outcome measures at 2-year follow-up (predictor analysis), and (aim 2) patients with MRI at both pre-treatment and 2-year follow-up. Outcome measures were visual analogue scale (VAS) for LBP, Oswestry Disability Index (ODI), work status and muscle fat infiltration on MRI. Patients with pre-treatment MRI and 2-year outcome data on VAS for LBP (n = 144), ODI (n = 147), and work status (n = 137) were analyzed for prediction purposes. At 2-year follow-up, 126 patients had another MRI scan, and change in muscle fat infiltration was compared between the two treatment groups. Three radiologists visually quantified multifidus muscle fat in the three lower lumbar levels on MRI as 50% (grade 2) of the muscle cross-section containing fat. Regression analysis and a mid-P exact test were carried out. <br> <br> Results: Grade 0 pre-treatment multifidus muscle fat predicted better clinical results at 2-year follow-up after TDR surgery (all outcomes) but not after rehabilitation. At 2-year follow-up, increased fat infiltration was more common in the surgery group (intention-to-treat p = 0.03, per protocol p = 0.08) where it was related to worse pain and ODI. <br> <br> Conclusions: Patients with less fat infiltration of multifidus muscles before TDR surgery had better outcomes at 2-year follow-up, but findings also indicated a negative influence of TDR surgery on back muscle morphology in some patients. The rehabilitation group maintained their muscular morphology and were unaffected by pre-treatment multifidus muscle fat.en_US
dc.description.sponsorshipNorwegian Fund for PostGraduate Training in Physiotherapy. The South Eastern Norway Regional,Health Authority. The Western Norway Regional Health Authority, Haakon. Sigrun Ødegaard’s Fund at the Norwegian Society of Radiology.en_US
dc.descriptionSource at <a href= https://doi.org/10.1186/s12891-017-1505-5>https://doi.org/10.1186/s12891-017-1505-5</a>.en_US
dc.identifier.citationStorheim, K., Berg, L., Hellum, C., Gjertsen, Ø., Neckelmann, G.F., Espeland, A. & Keller, A. (2017). Fat in the multifidus muscles - predictive value and change following disc prosthesis surgery and multidisciplinary rehabilitation in patients with chronic low back pain and degenerative disc disease: 2-year follow-up of a randomized trial. BMC Musculoskeletal Disorders,18(1):145. https://doi.org/10.1186/s12891-017-1505-5en_US
dc.identifier.cristinIDFRIDAID 1546715
dc.identifier.doi10.1186/s12891-017-1505-5
dc.identifier.issn1471-2474
dc.identifier.urihttps://hdl.handle.net/10037/12658
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.relation.journalBMC Musculoskeletal Disorders
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Fysikalsk medisin og rehabilitering: 764en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Physical medicine and rehabilitation: 764en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrokirurgi: 786en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurosurgery: 786en_US
dc.subjectMultifidus muscle faten_US
dc.subjectPredictive valueen_US
dc.subjectChange over timeen_US
dc.subjectChronic degenerative low back painen_US
dc.subjectMultidisciplinary rehabilitationen_US
dc.subjectPhysiotherapyen_US
dc.subjectSurgeryen_US
dc.subjectTotal disc replacementen_US
dc.titleFat in the multifidus muscles - predictive value and change following disc prosthesis surgery and multidisciplinary rehabilitation in patients with chronic low back pain and degenerative disc disease: 2 year follow-up of a randomized trial.en_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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