Ultrasonographic Assessment of Thoracolumbar Fascia in AxSpA and Controls With Trigger Point Evaluation

NCT ID: NCT06978374

Last Updated: 2025-05-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

132 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-11-01

Study Completion Date

2025-03-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The goal of this observational study is to evaluate whether changes in the thoracolumbar fascia (TLF)-a connective tissue in the lower back-are related to pain and disease severity in patients with axial spondyloarthropathy (ax-SpA), a chronic inflammatory spine condition. The study involves adults diagnosed with ax-SpA and healthy volunteers of similar age and gender.

The main questions it aims to answer are:

Is the thickness or shape of the thoracolumbar fascia different in patients with ax-SpA compared to healthy individuals? Is there a relationship between changes in the thoracolumbar fascia and the presence of painful muscle trigger points? Researchers will compare measurements in ax-SpA patients and healthy volunteers to see if differences in fascia structure are linked to pain, function, and disease activity.

Participants will:

Undergo a back ultrasound (non-invasive imaging) to assess the thickness and structure of the thoracolumbar fascia.

Be examined for muscle trigger points using gentle manual palpation. Complete questionnaires and assessments on physical function, quality of life, and disease activity.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The goal of this observational study is to explore whether structural changes in the thoracolumbar fascia (TLF)-a connective tissue layer in the lower back-are related to pain, stiffness, and disease activity in individuals with axial spondyloarthropathy (ax-SpA), a chronic inflammatory condition that affects the spine and can cause significant back pain and limited mobility. The study also examines whether these changes are linked to myofascial trigger points, which are sensitive or painful spots in the muscles.

This research includes adults diagnosed with ax-SpA, as well as healthy volunteers of similar age and gender who do not have chronic back pain or spinal diseases.

The main questions it aims to answer are:

Do patients with ax-SpA have increased thickness or irregular structure in the thoracolumbar fascia compared to healthy individuals? Is there a connection between fascia changes and the presence of painful muscle trigger points? Are these findings related to the severity of disease symptoms, such as pain, stiffness, physical function, and quality of life? Does the use of anti-inflammatory or immune-modulating medications affect the presence of these muscle trigger points? Researchers will compare ultrasound and clinical findings between ax-SpA patients and healthy volunteers to determine whether structural differences in the fascia can be used as a non-invasive indicator of disease burden.

Participants will:

Undergo a high-resolution ultrasound scan of their lower back to assess the structure and thickness of the thoracolumbar fascia.

Receive a manual examination to check for muscle trigger points in the lower back.

Complete questionnaires related to pain, function, fatigue, and quality of life.

Share information about their medical history, including the use of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and TNF-alpha inhibitors.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Axial Spondylarthritis (axSpA) Myofascial Trigger Point Pain (MTrP) Ultrasound Exams

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

AxSpA group

This study included individuals aged between 18 and 65 years who were classified as having axial spondyloarthritis (axSpA), including both radiographic and non-radiographic forms, according to the Assessment of SpondyloArthritis International Society (ASAS) classification criteria. Participants with additional health conditions that could affect thoracolumbar fascia (TLF) morphology or spinal biomechanics were excluded from the study. Exclusion criteria included: History of severe back or lower extremity trauma or surgery, Significant spinal deformity (e.g., scoliosis, kyphosis, spinal stenosis), History of spinal surgery, History of spinal fracture, Malignancy or spinal infection, Neurological deficit due to nerve root compression, Neurological or major psychiatric disorders, Bleeding disorders, Previous lumbar steroid injection or current systemic steroid use, Pregnancy, Disability status or ongoing legal process related to low back pain, Presence of acute systemic infection

Sonographic examination of thoracolumbar fascia, manual examination of MTrP

Intervention Type OTHER

Patients were positioned in the prone position, with a cushion placed under the abdomen to flatten the lumbar lordosis.

A 14-18 MHz linear transducer was used for ultrasonographic (USG) evaluation, performed with a GE Logiq P5 ultrasound device (Serial No: GE-114118SU3).

The USG probe was placed longitudinally at the L2-L3 intervertebral level, 2 cm lateral to the vertical line connecting the spinous processes on both sides, in order to assess the thoracolumbar fascia (TLF).

Healthy group

Participants in the healthy control group were age-matched (18-65 years) and selected according to the same exclusion criteria applied to the patient group.

Sonographic examination of thoracolumbar fascia, manual examination of MTrP

Intervention Type OTHER

Patients were positioned in the prone position, with a cushion placed under the abdomen to flatten the lumbar lordosis.

A 14-18 MHz linear transducer was used for ultrasonographic (USG) evaluation, performed with a GE Logiq P5 ultrasound device (Serial No: GE-114118SU3).

The USG probe was placed longitudinally at the L2-L3 intervertebral level, 2 cm lateral to the vertical line connecting the spinous processes on both sides, in order to assess the thoracolumbar fascia (TLF).

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Sonographic examination of thoracolumbar fascia, manual examination of MTrP

Patients were positioned in the prone position, with a cushion placed under the abdomen to flatten the lumbar lordosis.

A 14-18 MHz linear transducer was used for ultrasonographic (USG) evaluation, performed with a GE Logiq P5 ultrasound device (Serial No: GE-114118SU3).

The USG probe was placed longitudinally at the L2-L3 intervertebral level, 2 cm lateral to the vertical line connecting the spinous processes on both sides, in order to assess the thoracolumbar fascia (TLF).

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Individuals aged between 18 and 65 years
* Diagnosis of axial spondyloarthritis (axSpA) according to the Assessment of -SpondyloArthritis International Society (ASAS) classification criteria, or being a healthy control with no known musculoskeletal or systemic inflammatory disease
* Ability to lie in the prone position for ultrasonographic examination
* Willingness to participate in the study
* Provision of written informed consent prior to inclusion

Exclusion Criteria

* History of significant back or lower extremity trauma or orthopedic surgery
* Presence of major spinal deformities (e.g., scoliosis, kyphosis, spinal stenosis)
* History of spinal surgery or spinal fracture
* Known malignancy or spinal infection
* Neurological deficits due to nerve root compression
* Presence of a diagnosed neurological or major psychiatric disorder
* Known bleeding disorders
* History of lumbar steroid injection or current use of systemic corticosteroids
* Current pregnancy
* Legal or disability status related to low back pain
* Presence of an acute systemic infection
* Refusal or inability to provide written informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Ankara University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Yuzlem Gyuner SIDZHIMLI MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Sebnem ATAMAN, Study Chair

Role: STUDY_CHAIR

Ankara University School of Medicine, Department of Rheumathology

Yuzlem Gyuner SIDZHIMLI, MD

Role: PRINCIPAL_INVESTIGATOR

Ankara University School of Medicine, Department of Physical Medicine and Rehabilitation

Seçilay GÜNEŞ, Ass Prof

Role: STUDY_DIRECTOR

Ankara University School of Medicine, Department of Physical Medicine and Rehabilitation

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Ankara University, Faculty of Medicine Hospital

Ankara, Mamak, Turkey (Türkiye)

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Turkey (Türkiye)

References

Explore related publications, articles, or registry entries linked to this study.

De Coninck K, Hambly K, Dickinson JW, Passfield L. Measuring the morphological characteristics of thoracolumbar fascia in ultrasound images: an inter-rater reliability study. BMC Musculoskelet Disord. 2018 Jun 1;19(1):180. doi: 10.1186/s12891-018-2088-5.

Reference Type BACKGROUND
PMID: 29859080 (View on PubMed)

Abe H, Hayashi S, Kim JH, Murakami G, Rodriguez-Vazquez JF, Jin ZW. Fetal development of the thoracolumbar fascia with special reference to the fascial connection with the transversus abdominis, latissimus dorsi, and serratus posterior inferior muscles. Surg Radiol Anat. 2021 Jun;43(6):917-928. doi: 10.1007/s00276-020-02668-4. Epub 2021 Jan 12.

Reference Type BACKGROUND
PMID: 33438110 (View on PubMed)

Boccon Gibod L, Correas G, Godefroy D, Ducellier R, Teyssier P. [Radio-transparent renal calculi and epithelial tumours. Contribution of ultrasound and CT scan to the diagnosis (author's transl)]. Nouv Presse Med. 1981 Oct 31;10(39):3231-2. French.

Reference Type BACKGROUND
PMID: 7301552 (View on PubMed)

Kondrup F, Gaudreault N, Venne G. The deep fascia and its role in chronic pain and pathological conditions: A review. Clin Anat. 2022 Jul;35(5):649-659. doi: 10.1002/ca.23882. Epub 2022 Apr 27.

Reference Type BACKGROUND
PMID: 35417568 (View on PubMed)

Hodges PW, Danneels L. Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms. J Orthop Sports Phys Ther. 2019 Jun;49(6):464-476. doi: 10.2519/jospt.2019.8827.

Reference Type BACKGROUND
PMID: 31151377 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

AUPMRYGSThesis

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Blind Needling Accuracy in Lumbar Muscles
NCT07074249 NOT_YET_RECRUITING NA
Can We Reliably Needle Hip Muscles Blindly?
NCT07079033 NOT_YET_RECRUITING NA