This prospective observational study aims to investigate the association between subcutaneous fat index, paraspinal muscle characteristics, facet morphology, and lumbar facet joint degeneration in adults with chronic low back pain. The study will use lumbar magnetic resonance imaging (MRI) obtained as part of routine clinical care. The study will evaluate whether subcutaneous fat index is associated with moderate-to-severe lumbar facet joint degeneration and will also examine the relationships of disc degeneration, facet morphology, paraspinal muscle characteristics, and pain severity with facet joint degeneration.
Age 18-75 years.
Low back pain lasting for at least 3 months.
Evaluation at the Algology outpatient clinic.
Lumbar MRI has been clinically indicated as part of routine patient management independently of the study.
Previous lumbar spine surgery or lumbar fusion.
Acute vertebral fracture or significant lumbar trauma.
Spinal malignancy or vertebral metastasis.
Spondylodiscitis or other spinal infections.
Adults aged 18-75 years with chronic low back pain lasting at least 3 months who present to the Algology outpatient clinic of Marmara University Faculty of Medicine Pendik Training and Research Hospital and have a lumbar MRI clinically indicated as part of routine patient management independently of the study. Routine lumbar MRI images and demographic and clinical characteristics will be evaluated for associations between subcutaneous fat index, intervertebral disc degeneration, facet joint degeneration, facet morphology, and paraspinal muscle characteristics.
Cohort
Prospective
Lumbar Magnetic Resonance Imaging (MRI)
Diagnostic testLumbar MRI images obtained as part of routine clinical care will be evaluated for study purposes. No additional MRI examination or radiation exposure will be performed because of study participation. MRI findings will be assessed for subcutaneous fat index, intervertebral disc degeneration, facet joint degeneration, facet morphology, and paraspinal muscle characteristics.
Association between subcutaneous fat index and moderate-to-severe lumbar facet joint degeneration
Moderate-to-severe lumbar facet joint degeneration will be defined as Weishaupt Grade ≥2 in the right or left facet joint at any lumbar level from L1-L2 to L5-S1. The association with subcutaneous fat index measured on lumbar MRI will be evaluated.
Association between subcutaneous fat index and total Pfirrmann score
The association between subcutaneous fat index and total Pfirrmann score for lumbar intervertebral disc degeneration will be evaluated.
Association between intervertebral disc degeneration and facet joint degeneration
The association between intervertebral disc degeneration and lumbar facet joint degeneration will be evaluated using Pfirrmann and Weishaupt classifications.
Association between facet angle, facet tropism, and facet joint degeneration
The associations between facet angle, facet tropism, and lumbar facet joint degeneration will be evaluated.
Association between paraspinal muscle characteristics and intervertebral disc and facet joint degeneration
The associations between paraspinal muscle characteristics, including total cross-sectional area, functional cross-sectional area, and fat infiltration, and intervertebral disc and lumbar facet joint degeneration will be evaluated.
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