Cervical Extensor Muscles Play the Role on Malalignment of Cervical Spine

Wang, Dian; Ding, Yi; Wu, Bingxuan; Si, Fangda; Fan, Yu; Xiao, Bowei; Liu, Baoge

doi:10.1097/brs.0000000000003742

Cited by 5 publications

(17 citation statements)

References 37 publications

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“…Muscular FRR is an important function parameter. It has great reproducibility in the diagnosis and detection of muscular disorders and dysfunctional diseases, such as neck tension, and non‐specific muscular pain 18,19 . Lower FRR reveals FRP loss and muscle dysfunction, as the extensor muscles still maintain the tension during the relaxation phase 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…All the included LDH patients performed the sEMG test preoperatively. The sEMG‐based flexion–relaxation ratio (FRR) is a validated reliable neurophysiological parameter for assessing the flexion–relaxation phenomenon (FRP) of the spine musculature 18,19 . The FRP represents a normal muscular function and refers to extensors’ normal electrical activity silence during the relaxation phase 18,19 …”

Section: Methodsmentioning

confidence: 99%

“…Finally, the FRR of LM (FRR LM ) and ES (FRR ES ) were calculated. FRR = maximal activity during the re‐extension phase/mean activity during the relaxation phase 18,19 . A lower FRR indicates muscle dysfunction 18,19 .…”

Section: Methodsmentioning

confidence: 99%

“…The sEMG-based flexion-relaxation ratio (FRR) is a validated reliable neurophysiological parameter for assessing the flexion-relaxation phenomenon (FRP) of the spine musculature. 18,19 The FRP represents a normal muscular function and refers to extensors' normal electrical activity silence during the relaxation phase. 18,19 The muscle electrical activity of the lumbar multifidus (LM) and longissimus erector spinae (ES) during the flexion and re-extension task were measured by sEMG (FlexComp Infiniti System, T7550, Thought Technology, Canada).…”

Section: Patient Involvementmentioning

confidence: 99%

“…18,19 The FRP represents a normal muscular function and refers to extensors' normal electrical activity silence during the relaxation phase. 18,19 The muscle electrical activity of the lumbar multifidus (LM) and longissimus erector spinae (ES) during the flexion and re-extension task were measured by sEMG (FlexComp Infiniti System, T7550, Thought Technology, Canada). MF and longissimus ES are the main paravertebral muscles at L4-L5 (Figure 1A,B) and L5-S1 segments (Figure 1A,C).…”

Section: Patient Involvementmentioning

confidence: 99%

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Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

Li,

Xing,

et al. 2024

Orthopaedic Surgery

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ObjectiveSpinal endoscopy radiofrequency is a minimally invasive technique for lumbar disc herniation (LDH) and low back pain (LBP). However, recurring LDH/LBP following spinal endoscopy radiofrequency is a significant problem. Paravertebral musculature plays a crucial role in spine stability and motor function, and the purpose of the present study was to identify whether patients’ baseline lumbar muscular electrophysiological function could be a predictor of recurring LDH/LBP.MethodsThis was a prospective follow‐up and case‐control study focusing on elderly patients with LDH who were treated in our department between January 1, 2018, and October 31, 2021. The end of follow‐up was recurring LBP, recurring LDH, death, missing to follow‐up or 2 years postoperation. The surface electromyography test was performed before the endoscopy C‐arm radiofrequency (ECRF) operation to detect the flexion–relaxation ratio (FRR) of the lumbar multifidus (FRRLM) and the longissimus erector spinae (FRRES), and the other baseline parameters included the general characteristics, the visual analogue scale, the Japanese Orthopaedic Association score, and the Oswestry Disability Index. Intergroup comparisons were performed by independent t‐test and χ2‐test, and further binary logistic regression analysis was performed.ResultsFifty‐four patients completed the 2‐year follow‐up and were retrospectively divided into a recurring LDH/LBP group (Group R) (n = 21) and a no recurring group (Group N) (n = 33) according to their clinical outcomes. FRRLM and FRRES in Group N were much higher than those in Group R (p < 0.001, p = 0.009). Logistic regression analysis showed that only the FRRLM (odds ratio [OR] = 0.123, p = 0.011) and FRRES (OR = 0.115, p = 0.036) were independent factors associated with the ECRF outcome.ConclusionsLumbar disc herniation patients’ baseline FRRLM and FRRES are independent outcome predictors of recurring LDH/LBP after ECRF. For every unit increase in baseline FRRLM, the risk of recurring LDH/LBP is decreased by 87.7%, and for every unit increase in baseline FRRES, the risk of recurring LDH/LBP is decreased by 88.5%.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Patient Involvementmentioning

confidence: 99%

Section: Patient Involvementmentioning

confidence: 99%

See 3 more Smart Citations

Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

Li,

Xing,

et al. 2024

Orthopaedic Surgery

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A systematic review and meta analysis of measurement properties for the flexion relaxation ratio in people with and without non specific spine pain

De Carvalho,

Mackey,

et al. 2024

Sci Rep

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This review sought to identify, critically appraise, compare, and summarize the literature on the reliability, discriminative validity and responsiveness of the flexion relaxation ratio (FRR) in adults (≥ 18 years old) with or without spine pain (any duration), in either a clinical or research context. The review protocol was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/27EDF) and follows COSMIN, PRISMA, and PRESS guidelines. Six databases were searched from inception to June 1, 2022. The search string was developed by content experts and a health services librarian. Two pairs of reviewers independently completed titles/abstracts and full text screening for inclusion, data extraction, and risk of bias assessment (COSMIN RoB Toolkit). At all stages, discrepancies were resolved through consensus meetings. Data were pooled where possible with a three-level random effects meta-analyses and a modified GRADE assessment was used for the summary of findings. Following duplicate removal, 728 titles/abstracts and 219 full texts were screened with 23 included in this review. We found, with moderate certainty of evidence, that the cervical FRR has high test–retest reliability and lumbar FRR has moderate to high test–retest reliability, and with high certainty of evidence that the cervical and lumbar FRR can discriminate between healthy and clinical groups (standardized mean difference − 1.16 [95% CI − 2.00, − 0.32] and − 1.21 [− 1.84, − 0.58] respectively). There was not enough evidence to summarize findings for thoracic FRR discriminative validity or the standard error of measurement for the FRR. Several studies used FRR assuming responsiveness, but no studies were designed in a way that could confirm responsiveness. The evidence supports adequate reliability of FRR for the cervical and lumbar spine, and discriminative validity for the cervical and lumbar spine only. Improvements in study design and reporting are needed to strengthen the evidence base to determine the remaining measurement properties of this outcome.

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Is the flexion relaxation ratio a reliable, valid, and responsive measure for individuals with and without non-specific spine pain? A systematic review and meta-analysis

De Carvalho,

Mackey,

et al. 2023

Preprint

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This review sought to identify, critically appraise, compare, and summarize the literature on the reliability, discriminative validity and responsiveness of the Flexion Relaxation Ratio (FRR) in adults (≥ 18 years old) with or without spine pain (any duration), in either a clinical or research context. The review protocol was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/27EDF) and follows COSMIN, PRISMA, and PRESS guidelines. Six databases were searched from inception to June 1, 2022. The search string was developed by content experts and a health services librarian. Two pairs of reviewers independently completed titles/abstracts and full text screening for inclusion, data extraction, and risk of bias assessment (COSMIN RoB Toolkit). At all stages, discrepancies were resolved through consensus meetings. Data were pooled where possible with random effects meta-analyses and a modified GRADE assessment was used for the summary of findings. Following duplicate removal, 728 titles/abstracts and 219 full texts were screened with 55 included in this review. We found, with moderate certainty, that the cervical FRR has high test-retest reliability and lumbar FRR has moderate to high test-retest reliability, and with high certainty that the cervical and lumbar FRR can discriminate between healthy and clinical groups (standardized mean difference − 0.82 [95% CI -1.82, 0.17] and − 1.21 [-1.84, -0.58] respectively). There was not enough evidence to summarize findings for thoracic FRR discriminative validity or the standard error of measurement for the FRR in either the cervical, thoracic, or lumbar segments of the spine. Several studies that used FRR assumed responsiveness, but no studies were designed in a way that could confirm responsiveness. The evidence supports adequate reliability of FRR for the cervical and lumbar spine, and discriminative validity for the cervical and lumbar spine only. Improvements in study design and reporting are needed to strengthen the evidence base to determine the remaining measurement properties of this outcome.

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Cervical Extensor Muscles Play the Role on Malalignment of Cervical Spine

Cited by 5 publications

References 37 publications

Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

A systematic review and meta analysis of measurement properties for the flexion relaxation ratio in people with and without non specific spine pain

Is the flexion relaxation ratio a reliable, valid, and responsive measure for individuals with and without non-specific spine pain? A systematic review and meta-analysis

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