Abstract
Abstract
Objectives
Restricted sliding at lumbar myofascial interfaces may contribute to chronic low back pain with myofascial pain features (CLBP-MP). We aimed to evaluate magnetic resonance elastography (MRE)-based slip interface imaging (SII) to quantify lumbar intermuscular myofascial mobility in healthy volunteers (HV), assessing repeatability, and comparing CLBP-MP patients with matched HV.
Materials and methods
MRE/SII was performed in 20 CLBP-MP patients and 41 HV. SII-derived maximal normalized displacement discontinuity (Dnorm) was analyzed at the quadratus lumborum–erector spinae (QL–ES) and ES–multifidus (ES–M) interfaces at L3–L4, computing mobility indices. Repeatability was assessed
via
within-subject coefficient of variation (wCV) and Bland–Altman analysis. In HV, associations with age/sex/body mass index (BMI) were tested. Group differences were evaluated by comparing patients with matched HV and by stratifying patients by “pain, enjoyment, and general activity” (PEG) score using one-way ANOVA. Associations with PEG were evaluated using Pearson correlation.
Results
Repeatability was excellent (mean wCV p
versus
mild pain (
q
= 0.023) and
versus
HV (
q
r
= −0.51,
p
= 0.021).
Conclusion
Pain-related reductions in localized lumbar intermuscular myofascial mobility in CLBP-MP were shown. MRE-based SII is a repeatable quantitative technique, supporting its potential as an early-stage biomarker for characterizing lumbar myofascial mobility and guiding multicenter studies.
Key Points
Question
Lumbar myofascial interface sliding is essential for normal movement, but objective quantification of sliding dysfunction in chronic low back pain remains limited.
Findings
SII showed high repeatability and reduced L4 erector spinae-multifidus mobility associated with greater pain severity in chronic low back pain patients.
Relevance statement
MR elastography-based SII offers repeatable, noninvasive measurement of lumbar myofascial mobility and shows pain-related localized restriction in chronic low back pain with myofascial features, supporting objective characterization of inter-muscular myofascial mechanics and exploratory biomarker development.