Norio Tomita, Marie-Hélène Roy-Cardinal, Boris Chayer, Stacey Daher, Ameer Attiya, Aline Boulanger, Nathaly Gaudreault, Guy Cloutier, Nathalie J Bureau
{"title":"胸腰筋膜超声剪切应变在腰痛和无症状个体之间的差异：扩大证据。","authors":"Norio Tomita, Marie-Hélène Roy-Cardinal, Boris Chayer, Stacey Daher, Ameer Attiya, Aline Boulanger, Nathaly Gaudreault, Guy Cloutier, Nathalie J Bureau","doi":"10.1186/s13244-024-01895-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To compare thoracolumbar fascia (TLF) shear strain between individuals with and without nonspecific low back pain (NSLBP), investigate its correlation with symptoms, and assess a standardized massage technique's impact on TLF shear strain.</p><p><strong>Methods: </strong>Participants were prospectively enrolled between February 2021 and June 2022. Pre- and post-intervention TLF ultrasound and pain/disability questionnaires were conducted. Cumulated (C|ShS|<sub>L</sub>) and maximum (Max|ShS|<sub>L</sub>) shear strain parameters were computed from radiofrequency data, and TLF thickness was measured on reconstructed B-mode images. Statistical analysis included linear mixed-effects regression.</p><p><strong>Results: </strong>Thirty-two NSLBP participants (mean age, 57 ± 9 years [standard deviation]; 21 women) and 32 controls (51 ± 10 years; 22 women) (p = 0.02) were enrolled. The mean shear strain was higher in NSLBP participants (C|ShS|<sub>L</sub>: 327.1% ± 106.0 vs 290.2% ± 99.8, p < 0.0001; Max|ShS|<sub>L</sub>: 8.1% ± 2.8 vs 7.0% ± 2.4, p < 0.0001) than controls, while mean TLF thickness (1.6 mm ± 1.0 vs 1.5 mm ± 0.9; p = 0.43) was comparable. Elastography parameters correlated with pain [C|ShS|<sub>L</sub> estimate [β], 0.01 [95% CI: 0.002, 0.02]; p = 0.02); Max|ShS|<sub>L</sub> [β]<sub>,</sub> 0.003 [95% CI: 0.001, 0.005]; p < 0.001)] and disability [C|ShS|<sub>L</sub> [β] 0.02 [95% CI: 0.005, 0.03]; p = 0.009); Max|ShS|<sub>L</sub> [β] 0.003 [95% CI: 0.001, 0.006]; p = 0.002)] scores. Neither C|ShS|<sub>L</sub> (β, 0.13 [-0.27, 0.53]; p = 0.53) nor Max|ShS|<sub>L</sub> (β, -0.02 [-0.10, 0.05]; p = 0.59) changed post-intervention.</p><p><strong>Conclusion: </strong>Individuals with NSLBP demonstrated elevated TLF shear strain compared to controls, with similar TLF thickness. The shear strain correlated with pain and disability scores, yet a brief massage did not influence shear strain.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT04716101. Registered 14 January 2021, https://clinicaltrials.gov/study/NCT04716101 .</p><p><strong>Critical relevance statement: </strong>Ultrasound shows elevated TLF shear strain in lower back pain sufferers compared to controls. This correlates with symptoms, suggesting a role as a pain generator. Further investigation into its anatomy, mechanical characteristics, and pathophysiology is crucial for better understanding.</p><p><strong>Key points: </strong>Structural and mechanical alterations of the TLF may contribute to low back pain. Elevated TLF lateral shear strain was found in patients with NSLBP. A brief standardized massage therapy technique did not influence elastography parameters.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"18"},"PeriodicalIF":4.1000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735703/pdf/","citationCount":"0","resultStr":"{\"title\":\"Thoracolumbar fascia ultrasound shear strain differs between low back pain and asymptomatic individuals: expanding the evidence.\",\"authors\":\"Norio Tomita, Marie-Hélène Roy-Cardinal, Boris Chayer, Stacey Daher, Ameer Attiya, Aline Boulanger, Nathaly Gaudreault, Guy Cloutier, Nathalie J Bureau\",\"doi\":\"10.1186/s13244-024-01895-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To compare thoracolumbar fascia (TLF) shear strain between individuals with and without nonspecific low back pain (NSLBP), investigate its correlation with symptoms, and assess a standardized massage technique's impact on TLF shear strain.</p><p><strong>Methods: </strong>Participants were prospectively enrolled between February 2021 and June 2022. Pre- and post-intervention TLF ultrasound and pain/disability questionnaires were conducted. Cumulated (C|ShS|<sub>L</sub>) and maximum (Max|ShS|<sub>L</sub>) shear strain parameters were computed from radiofrequency data, and TLF thickness was measured on reconstructed B-mode images. Statistical analysis included linear mixed-effects regression.</p><p><strong>Results: </strong>Thirty-two NSLBP participants (mean age, 57 ± 9 years [standard deviation]; 21 women) and 32 controls (51 ± 10 years; 22 women) (p = 0.02) were enrolled. The mean shear strain was higher in NSLBP participants (C|ShS|<sub>L</sub>: 327.1% ± 106.0 vs 290.2% ± 99.8, p < 0.0001; Max|ShS|<sub>L</sub>: 8.1% ± 2.8 vs 7.0% ± 2.4, p < 0.0001) than controls, while mean TLF thickness (1.6 mm ± 1.0 vs 1.5 mm ± 0.9; p = 0.43) was comparable. Elastography parameters correlated with pain [C|ShS|<sub>L</sub> estimate [β], 0.01 [95% CI: 0.002, 0.02]; p = 0.02); Max|ShS|<sub>L</sub> [β]<sub>,</sub> 0.003 [95% CI: 0.001, 0.005]; p < 0.001)] and disability [C|ShS|<sub>L</sub> [β] 0.02 [95% CI: 0.005, 0.03]; p = 0.009); Max|ShS|<sub>L</sub> [β] 0.003 [95% CI: 0.001, 0.006]; p = 0.002)] scores. Neither C|ShS|<sub>L</sub> (β, 0.13 [-0.27, 0.53]; p = 0.53) nor Max|ShS|<sub>L</sub> (β, -0.02 [-0.10, 0.05]; p = 0.59) changed post-intervention.</p><p><strong>Conclusion: </strong>Individuals with NSLBP demonstrated elevated TLF shear strain compared to controls, with similar TLF thickness. The shear strain correlated with pain and disability scores, yet a brief massage did not influence shear strain.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT04716101. Registered 14 January 2021, https://clinicaltrials.gov/study/NCT04716101 .</p><p><strong>Critical relevance statement: </strong>Ultrasound shows elevated TLF shear strain in lower back pain sufferers compared to controls. This correlates with symptoms, suggesting a role as a pain generator. Further investigation into its anatomy, mechanical characteristics, and pathophysiology is crucial for better understanding.</p><p><strong>Key points: </strong>Structural and mechanical alterations of the TLF may contribute to low back pain. Elevated TLF lateral shear strain was found in patients with NSLBP. A brief standardized massage therapy technique did not influence elastography parameters.</p>\",\"PeriodicalId\":13639,\"journal\":{\"name\":\"Insights into Imaging\",\"volume\":\"16 1\",\"pages\":\"18\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-01-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735703/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Insights into Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13244-024-01895-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-024-01895-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Thoracolumbar fascia ultrasound shear strain differs between low back pain and asymptomatic individuals: expanding the evidence.
Objectives: To compare thoracolumbar fascia (TLF) shear strain between individuals with and without nonspecific low back pain (NSLBP), investigate its correlation with symptoms, and assess a standardized massage technique's impact on TLF shear strain.
Methods: Participants were prospectively enrolled between February 2021 and June 2022. Pre- and post-intervention TLF ultrasound and pain/disability questionnaires were conducted. Cumulated (C|ShS|L) and maximum (Max|ShS|L) shear strain parameters were computed from radiofrequency data, and TLF thickness was measured on reconstructed B-mode images. Statistical analysis included linear mixed-effects regression.
Results: Thirty-two NSLBP participants (mean age, 57 ± 9 years [standard deviation]; 21 women) and 32 controls (51 ± 10 years; 22 women) (p = 0.02) were enrolled. The mean shear strain was higher in NSLBP participants (C|ShS|L: 327.1% ± 106.0 vs 290.2% ± 99.8, p < 0.0001; Max|ShS|L: 8.1% ± 2.8 vs 7.0% ± 2.4, p < 0.0001) than controls, while mean TLF thickness (1.6 mm ± 1.0 vs 1.5 mm ± 0.9; p = 0.43) was comparable. Elastography parameters correlated with pain [C|ShS|L estimate [β], 0.01 [95% CI: 0.002, 0.02]; p = 0.02); Max|ShS|L [β], 0.003 [95% CI: 0.001, 0.005]; p < 0.001)] and disability [C|ShS|L [β] 0.02 [95% CI: 0.005, 0.03]; p = 0.009); Max|ShS|L [β] 0.003 [95% CI: 0.001, 0.006]; p = 0.002)] scores. Neither C|ShS|L (β, 0.13 [-0.27, 0.53]; p = 0.53) nor Max|ShS|L (β, -0.02 [-0.10, 0.05]; p = 0.59) changed post-intervention.
Conclusion: Individuals with NSLBP demonstrated elevated TLF shear strain compared to controls, with similar TLF thickness. The shear strain correlated with pain and disability scores, yet a brief massage did not influence shear strain.
Trial registration: Clinicaltrials.gov, NCT04716101. Registered 14 January 2021, https://clinicaltrials.gov/study/NCT04716101 .
Critical relevance statement: Ultrasound shows elevated TLF shear strain in lower back pain sufferers compared to controls. This correlates with symptoms, suggesting a role as a pain generator. Further investigation into its anatomy, mechanical characteristics, and pathophysiology is crucial for better understanding.
Key points: Structural and mechanical alterations of the TLF may contribute to low back pain. Elevated TLF lateral shear strain was found in patients with NSLBP. A brief standardized massage therapy technique did not influence elastography parameters.
期刊介绍：
Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere!
I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe.
Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy.
A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field.
I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly.
The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members.
The journal went open access in 2012, which means that all articles published since then are freely available online.
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