The AAO Journal, 2025/06, 35(2):11. doi: 10.53702/i2375-5717-35.2.5, type of study: ,obs,

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p5.xml)

Keywords:

biomarkers [21]
chronic pain [323]
elastography [7]
low back pain [523]
observational study [246]
thoracolumbar fascia [5]

Abstract:

Introduction: The TLF’s role in proprioception, nociception, and both active and passive forces may contribute to low back pain (LBP). Shear Wave Elastography (SWE) is a form of ultrasound that determines the stiffness of tissue by measuring velocity of shear waves passing through soft-tissues. We hypothesize that a greater shear wave velocity at specific key transition zones of the posterior layer of TLF can predict CLBP subjects compared to patients with no LBP (NLBP). Methods: Preliminary SWE analysis comparing CLBP to NLBP subjects were taken from AOA and DOD funded prospective studies (single factor, repeated measure design) that shared a common asymptomatic population and image assessment protocol. Subjects age 18 to 50 with BMI ≤ 30 were included. Two SWE images were obtained in both longitudinal and transverse orientations at 9 key transition zones of the TLF bilaterally and 1 centrally (23 regions total). Three regions of interest were sampled per image and averaged. These averages between CLBP and NLBP were compared at each location and probe orientation. A one-tail T-test was used for significance, with p- value of 0.05. Results: Preliminary data of 31 subject’s baseline scans (13 NLBP and 18 CLBP) showed statistically significant increased stiffness in 7 locations for CLBP patients. Conclusion: This preliminary report suggests that SWE can demonstrate a significant increase in stiffness of regions of the TLF in subjects with CLBP, indicating potential use as a biomarker. The study is currently limited by preliminary mid-study results and pending post-treatment assessments. In addition, subjects with higher BMI made it difficult to interpret some TLF zones. Further research could include larger sampling, as well as blinded prospective pre- and post-treatment studies of the significant regions.