Simultaneous measurement of intramuscular pressure and surface electromyography of the multifidus muscle

Abstract

The anatomic proof of a spinal compartment and the clinical symptoms of compartment syndrome in patients with chronic back pain are inconsistent with the rarely met measuring criteria of intramuscular pressure (IMP). Previous studies assume a dependence of the IMP on spinal alignment (degree of lumbar spine flexion) and the degree of muscle activation. The significance of these disturbance variables in the interpretation of IMP could explain the above discrepancy. This study therefore investigates the influence of both a 30% increase in trunk flexion and alterations in muscle contraction from 100% to 60%. Sixteen healthy subjects participated in the study. The IMP and mean rectified amplitude of the multifidus surface EMG signal were determined at rest and 0 degrees and approximately 30 degrees of lumbar spine flexion, and they were compared. Subsequently, both parameters were measured during both 100% and 60% maximal voluntary contraction (MVC) of the muscle and then correlated. During rest and 0 degrees flexion, the median IMP was 9.3 mmHg (range 0.0-22.5) while the median mean rectified amplitude (MRA) of the EMG signal was 1.98 microV (range 1.32-7.38). In 30 degrees flexion, the median IMP went up to 24.3 mmHg (range 1.4-97.3) with hardly any increase in the median MRA of 2.32 microV (range 1.20-9.72). Under 60% MVC, the median IMP rose to 186.6 mmHg (range 15.4-375.4) and the median MRA to 21.02 microV (range 4.63-43.63). During 100% MVC, the median MRA increased to 34.38 microV (range 12.99-102.54) while the median IMP rose to 273.4 mmHg (range 90.4-395.1). Spearman's rank correlation coefficient for the IMP and MRA quotients of the 100/60% MVC values was r= -0.21. To sum up, it can be said that IMP was subject to great interindividual variation in all the experiments. This parameter is highly dependent on spinal alignment and muscular activity. Further studies are needed so that the IMP can be interpreted properly when diagnosing a chronic compartment of the erector spinae muscles.

Intramuscular pressure of the multifidus muscle and low-back pain after posterior lumbar interbody fusion: comparison of mini-open and conventional approaches

“…To the best of our knowledge, ours is the first study of intramuscular pressure after surgery. Lumbar intramuscular pressure at rest in healthy human adults in the prone position is 8.3-10 mm Hg, 12,13,20 in the lateral decubitus position it is 16 mm Hg, 12 and in the supine position it is 18 mm Hg. 12 In this prospective study, intramuscular pressure did not differ significantly between the 2 procedures, not only when measured with patients in the supine position but also when measured with patients in the lateral decubitus position.…”

“…12, 13 Kobayashi et al reported that, in a rat model, increasing the intramuscular pressure in paraspinal muscles decreased intramuscular blood flow and increased expression of neuropeptide in the dorsal root ganglion, thereby causing low-back pain.…”

The Impact of Diabetes Mellitus on Patients Undergoing Cervical Spondylotic Myelopathy: A Meta-Analysis

“…There have been several studies showing the influences of diabetic neuropathy and/or angiopathy on the outcomes of lumbar spine surgery [13][14][15] . However, for the impact of diabetes on patients undergoing CSM, there have been limited number of studies reporting this, and their results remain controversial.…”

“…Previous studies have reported that the diabetic neuropathy and/or angiopathy have negative effects on the outcomes of lumbar spine surgery [13][14][15] .…”

Resting Electromyographic Activity of Deep Thoracic Transversospinalis Muscles Identified as Abnormal With Palpation

“…36,37 Exploring these regions using measurement of intramuscular pressure with specialized probes may also be feasible. 38,39 Shah et al 40,41 developed a technique for measuring the local biochemical milieu of skeletal muscle to determine the presence of inflammatory mediators in trapezius muscle trigger points, and this Abbreviations: AbP, abnormal-to-palpation; ES1, erector spinae muscles adjacent to NP1; ES2, erector spinae muscles adjacent to NP2; ESA, erector spinae muscles adjacent to AbP; MVIC, mean voluntary isometric contractions; NP1, normal to palpation, above AbP site; NP2, normal to palpation, below AbP site.…”