Disclosures: Alicia Roldan, DO: No financial relationships or conflicts of interest

Objective: The purpose of this study is to review published research that used ultrasound imaging (USI) to quantitatively assess thoracolumbar fascia (TLF) morphology in humans. Given the complexity of this fascia and user dependence of USI, we sought to understand if existing literature sufficiently sampled the breadth of the TLF, clearly defined the layers studied and adequately assessed inter- and intra-rater reliability.

Design: PubMed, Science Direct, Medline Complete and Cochrane Library databases were searched from January 2000 through February 2021. Two independent reviewers evaluated manuscripts for study inclusion.Setting : Literature reviewParticipants : Studies were included that quantify specific morphologic or biomechanical properties of the TLF using USI in human participants with or without LBP. Studies were excluded if they were animal studies, not published in English, did not use USI, lacked quantitative outcome measures achieved by morphological assessment with USI, or were conference papers, case reports, abstracts or systematic reviews.

Interventions: Analysis of published research

Main Outcome Measures: Thickness, echogenicity, tissue displacement, elasticity

Results: A total of 140 studies were identified after removing duplicates. Eight studies met inclusion criteria. Seven studies examined TLF thickness, echogenicity, or tissue displacement (shear strain). One study used SWE to measure TLF elasticity.Conclusions: This review reveals that gray-scale US and SWE are useful, noninvasive modalities capable of visualizing morphological and biomechanical alterations within the TLF in real-time dynamic examinations. However, there is a need for further exploration of the examined objectives. The majority of studies have narrowly focused their assessment to the L2-3 interspace and provide few similarities to allow for comparisons of outcome or reproducibility. They also lack consensus on the sonographic delineation of the TLF and adequate inter- and intra-rater reliability testing. Future studies should focus on improving these methodologies.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/quantitative-sonographic-assessment-of-the-thoracolumbar-fascia-a-systematic-review/