Deze pagina is automatisch vertaald en de nauwkeurigheid van de vertaling kan niet worden gegarandeerd. Raadpleeg de Engelse versie voor een brontekst.

Association of Subcutaneous Fat Index, Paraspinal Muscle Characteristics, and Facet Morphology With Lumbar Facet Joint Degeneration

30 september 2026 bijgewerkt door: Marmara University

Subkutan Yağ İndeksi, Paraspinal Kas Özellikleri ve Faset Morfolojisinin Lomber Faset Eklem Dejenerasyonu Ile İlişkisi: Disk Dejenerasyonunun Olası Aracılık Rolü

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.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

This is a prospective, non-interventional observational clinical study conducted in patients with chronic low back pain. Participants will be adults aged 18 to 75 years who present to the Algology outpatient clinic of Marmara University Pendik Training and Research Hospital and who have a clinical indication for lumbar MRI as part of routine patient care, independent of study participation.

No additional MRI examinations, radiation exposure, medication administration, injections, or invasive procedures will be performed for research purposes. Participation in the study will not alter the patients' routine diagnostic, treatment, or follow-up procedures.

Demographic and clinical characteristics, including age, sex, height, weight, body mass index, smoking status, diabetes mellitus, hypertension, duration and severity of low back pain, and the presence of leg or radicular pain, will be recorded. Pain severity will be assessed using the Numeric Rating Scale.

Lumbar MRI images obtained during routine clinical care will be evaluated for subcutaneous fat index, intervertebral disc degeneration, facet joint degeneration, facet joint angle and tropism, paraspinal muscle cross-sectional area and fat infiltration, and Modic changes. Subcutaneous fat index will be measured at the L1-L2 level. Intervertebral disc degeneration will be assessed using the Pfirrmann classification, while facet joint degeneration will be assessed using the Weishaupt classification. Facet tropism will be calculated as the absolute difference between the right and left facet joint angles. Paraspinal muscle measurements will be performed at the L3-L4, L4-L5, and L5-S1 levels for the multifidus and erector spinae muscles.

The primary objective is to evaluate the association between subcutaneous fat index and moderate-to-severe lumbar facet joint degeneration. Secondary objectives include evaluating the relationships between subcutaneous fat index and total disc degeneration, disc degeneration and facet joint degeneration, facet morphology and facet joint degeneration, paraspinal muscle characteristics and disc or facet joint degeneration, and subcutaneous fat index and pain severity. An exploratory mediation analysis will also assess the potential mediating role of disc degeneration in the relationship between subcutaneous fat index and facet joint degeneration.

Imaging assessments will be performed by an evaluator blinded to pain severity, body mass index, and other clinical findings. Inter-rater or intra-rater reliability will be assessed in a randomly selected subset of approximately 20% of the study sample.

Studietype

Observationeel

Inschrijving (Geschat)

300

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

    • Istanbul
      • Istanbul, Istanbul, Turkije (Türkiye), 34890
        • Werving
        • Marmara University Pendik Training and Research Hospital
        • Contact:
        • Hoofdonderzoeker:
          • Osman Hakan Gündüz, Prof.Dr.

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 75 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

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.

Beschrijving

Inclusion Criteria:

-

Inclusion Criteria:

  1. Age 18-75 years.
  2. Low back pain lasting for at least 3 months.
  3. Evaluation at the Algology outpatient clinic.
  4. Lumbar MRI has been clinically indicated as part of routine patient management independently of the study.
  5. Lumbar MRI images including sagittal T1-weighted, sagittal T2-weighted, and axial T2-weighted images covering the L1-L2 through L5-S1 levels.
  6. Height and body weight can be measured.
  7. Low back pain severity can be assessed using the Numeric Rating Scale (NRS).
  8. Sufficient cognitive and linguistic capacity to complete the Oswestry Disability Index.
  9. Ability to understand the study and provide informed consent.
  10. Written informed consent to participate in the study.

Exclusion Criteria:

  1. Previous lumbar spine surgery or lumbar fusion.
  2. Acute vertebral fracture or significant lumbar trauma.
  3. Spinal malignancy or vertebral metastasis.
  4. Spondylodiscitis or other spinal infections.
  5. Inflammatory spondyloarthritis.
  6. Advanced lumbar scoliosis.
  7. Severe congenital lumbar vertebral anomaly.
  8. Anatomic variation preventing reliable identification of vertebral levels.
  9. Pregnancy.
  10. Inability to complete the MRI examination.
  11. MRI images inadequate for assessment of subcutaneous fat, intervertebral discs, facet joints, or paraspinal muscles.
  12. Missing clinical data or required outcome measures.
  13. Failure to provide written informed consent.

Exclusion Criteria:

-

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Observatiemodellen: COHORT
  • Tijdsperspectieven: PROSPECTIVE

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
Chronic Low Back Pain Cohort

Participants with chronic low back pain who meet the eligibility criteria and undergo lumbar MRI as part of routine clinical care will be included in this observational cohort. MRI findings and demographic and clinical characteristics will be evaluated to investigate the associations between subcutaneous fat index, paraspinal muscle characteristics, facet morphology, intervertebral disc degeneration, and lumbar facet joint degeneration.

Lumbar 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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Association between subcutaneous fat index and moderate-to-severe lumbar facet joint degeneration
Tijdsspanne: At baseline

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.

At baseline

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Association between subcutaneous fat index and total Pfirrmann score
Tijdsspanne: At baseline

The association between subcutaneous fat index and total Pfirrmann score for lumbar intervertebral disc degeneration will be evaluated.

At baseline
Association between intervertebral disc degeneration and facet joint degeneration
Tijdsspanne: At baseline

The association between intervertebral disc degeneration and lumbar facet joint degeneration will be evaluated using Pfirrmann and Weishaupt classifications.

At baseline
Association between facet angle, facet tropism, and facet joint degeneration
Tijdsspanne: At baseline

The associations between facet angle, facet tropism, and lumbar facet joint degeneration will be evaluated.

At baseline
Association between paraspinal muscle characteristics and intervertebral disc and facet joint degeneration
Tijdsspanne: At baseline

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.

At baseline
Association between subcutaneous fat index and low back pain severity
Tijdsspanne: At baseline

The association between subcutaneous fat index and low back pain severity will be evaluated using the Numeric Rating Scale (NRS).

At baseline
Exploratory mediation analysis of intervertebral disc degeneration in the association between subcutaneous fat index and facet joint degeneration
Tijdsspanne: At baseline

The potential statistical mediation role of intervertebral disc degeneration in the association between subcutaneous fat index and lumbar facet joint degeneration will be evaluated as an exploratory analysis.

At baseline

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: OSMAN H GÜNDÜZ, Marmara University

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 september 2026

Primaire voltooiing (Geschat)

1 juni 2027

Studie voltooiing (Geschat)

1 juni 2027

Studieregistratiedata

Eerst ingediend

30 september 2026

Eerst ingediend dat voldeed aan de QC-criteria

30 september 2026

Eerst geplaatst (Werkelijk)

6 oktober 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

6 oktober 2026

Laatste update ingediend die voldeed aan QC-criteria

30 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • 09.2026.26-0770

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

Individual participant data will not be shared with other researchers because no plan for individual participant data sharing has been established for this study.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .