Correlation Between the MRI Changes in the Lumbar Multifidus Muscles and Leg Pain

Kader, Deiary F.; Wardlaw, Douglas; Smith, Francis W.

doi:10.1053/crad.1999.0340

Cited by 390 publications

(339 citation statements)

References 10 publications

(18 reference statements)

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“…There is a growing body of evidence for association between paraspinal muscles degeneration and LBP. In several imaging studies, LBP has been investigated in relation to paraspinal muscle CSA [1,6,12,14,16,28,41,47,48,52], MRI signal intensity [10], and fat infiltration [1,6,12,14,19,21,23,28,32,41,47,52]. In patients with chronic LBP, studies consistently show a decrease in CSA [6,12,23], which may reach 10% compared to healthy individuals [19].…”

Section: Discussionmentioning

confidence: 99%

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

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The objectives of the study were to evaluate the association between lumbar paraspinal muscle density, evaluated on computed tomography (CT) and age, sex and BMI; and to evaluate the association of those changes with low back pain (LBP) and spinal degeneration features in a community-based sample. This study was an ancillary project to the Framingham Study. A sample of 3,529 participants aged 40-80 years had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this study. LBP in the last 12 months was evaluated using self-report questionnaire. Density (in Hounsfield units) of multifidus and erector spinae was evaluated on CT. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (FJOA), spondylolysis, spondylolisthesis and spinal stenosis were also evaluated. We used linear regression models to examine the association of paraspinal muscles density with age, sex, BMI, LBP, and spinal degeneration features. The results show that in our study, men have higher density of paraspinal muscles than women, younger individuals have higher density than older ones and individuals with lower weight have higher muscle density than overweight. No differences between individuals with and without LBP were found. Significant association was found between L4 multifidus/erector spinae density and FJOA at L4-L5; between multifidus at L4 and spondylolisthesis at L4-5; and between erector spinae at L4 and L5 with disc narrowing at L4-5 and L5-S1, respectively. We conclude that the paraspinal muscle density decreases with age, and increases BMI. It is associated with at some levels FJOA, spondylolisthesis and disc narrowing at the same level, but not associated with occurrence of LBP.

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Section: Discussionmentioning

confidence: 99%

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

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“…There was substantial intra-and interobserver agreement. We graded the MFM on the basis of T2-weighted MRI using a grading system used in our hospital [9]. There was good to substantial intra-and interobserver agreement (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…The disc height was measured by Pope's method [17]. The state of the MFM was graded according to the Woodend classification of MFM [9]. These assessments were repeated at 4 weeks to check for the reliability of the reading.…”

Section: Methodsmentioning

confidence: 99%

Correlation between inter-vertebral disc morphology and the results in patients undergoing Graf ligament stabilisation

et al. 2004

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Background. Previous studies have shown Graf ligament stabilisation procedure to give mixed results in the short to medium term. The aim of this study was to correlate the pre-operative state of the disc, multifidus muscles, age of the patient, levels operated and the clinical outcome after a mean follow-up of 47 months. Methods. Graf ligament stabilisationprocedure was carried out in 38 patients between 1996 and1999. Their post-operative status was assessed using MacNab criteria. The postoperative follow-up was by postal questionnaires and review of the clinical notes. Disc morphology and multifidus muscle wasting was graded blindly and independently. The intra-and interobserver reliability was measured with kappa score and classified using the kappa classification of Landis and Koch. Correlation was measured with the help of Spearman correlation coefficient. Results. Thirty-eight patients (100%)returned the questionnaires. Mean follow-up time was 47.55 months. Fifty-nine levels were operated on. Mean age was 39.68 years. The overall re-operation rate was 15.8%. The intra-and interobserver reliability was graded as good to substantial. Twenty-two patients (57.89%) were satisfied with the procedure. There was no statistically significant correlation between disc morphology, multifidus muscle wasting, sex, age, number of levels operated, the levels operated, and the satisfaction rate.Conclusions. The indications of Graf ligament stabilisation procedure are not clear. Further work is necessary to clearly identify the indication for the procedure.

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“…Interestingly, there is no correlation between obesity and the presence of fat in LMM [16]. About 80% of people suffering from CLBP present LMM with increased fat infiltration between levels L2 to L5 [10,16,17]. Increased fat infiltration in association with pain, age or dysfunction has also been reported in other muscles [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain

et al. 2015

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Background: Lumbar multifidus muscles (LMM) are important for spinal motion and stability. Low back pain (LBP) is often associated with fat infiltration in LMM. An increasing fat infiltration of LMM may lead to lumbar dysfunction. The purpose of this study was to investigate whether there is a correlation between the severity of lumbar dysfunction and the severity of fat infiltration of LMM. Methods: In a cross-sectional study, 42 patients with acute or chronic LBP were recruited. Their MRI findings were visually rated and graded using three criteria for fat accumulation in LMM: Grade 0 (0-10%), Grade 1 (10-50%) and Grade 2 (>50%). Lumbar sagittal range of motion, dynamic upright and seated posture control, sagittal movement control, body awareness and self-assessed functional disability were measured to determine the patients' low back dysfunction. Results: The main result of this study was that increased severity of fat infiltration in the lumbar multifidus muscles correlated significantly with decreased range of motion of lumbar flexion (p = 0.032). No significant correlation was found between the severity of fat infiltration in LMM and impaired movement control, posture control, body awareness or self-assessed functional disability. Conclusion: This is the first study investigating the relationship between the severity of fat infiltration in LMM and the severity of lumbar dysfunction. The results of this study will contribute to the understanding of the mechanisms leading to fat infiltration of LMM and its relation to spinal function. Further studies should investigate whether specific treatment strategies are effective in reducing or preventing fat infiltration of LMM.

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Correlation Between the MRI Changes in the Lumbar Multifidus Muscles and Leg Pain

Cited by 390 publications

References 10 publications

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Correlation between inter-vertebral disc morphology and the results in patients undergoing Graf ligament stabilisation

Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain

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