Study on the cross-sectional area of the multifidus muscle at the L4-L5 level on ultrasound images of Olympic-style weightlifting and judo athletes

Abstract

BACKGROUND: The multifidus muscle is located near the spine and controls the erection of the spine and stabilization during movements of the spine and extremities, and assists in all other spinal movements. Differences in paraspinal muscles between sides and levels, particularly in he multifidus, have been proposed as possible indicators of low back pain or spinal pathology. OBJECTIVE: This study aims to examine the cross-sectional area of the lumbar multifidus muscle at L4-L5 vertebral levels on ultrasound images of athletes in Olympic-style weightlifting, judo athletes and sedentary individuals. METHODS: This study included asymptomatic male athletes (athletes in Olympic-style weightlifting, n= 17, age: 19.24 ± 1.88, judo athletes, n= 17, age: 19.18 ± 1.23) and sedentary individuals (n= 17, age: 19.88 ± 1.31). The cross-sectional area of lumbar multifidus muscles was assessed bilaterally at the L4-L5 segments level in prone and using ultrasound imaging. RESULTS: Lumbar multifidus muscle cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes were larger than those of sedentary individuals (p< 0.004). No asymmetric development was observed in cross-sectional areas of right-left lumbar multifidus muscle at L4-L5 levels of athletes in Olympic-style weightlifting and sedentary individuals (p> 0.008). The cross-sectional areas of the right and left lumbar multifidus muscle at L5 segment of individuals in judo athletes was found to be asymmetrical (p< 0.008). CONCLUSION: Our study shows that the cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes are larger than that of sedentary individuals. The difference in the cross-sectional area of the lumbar multifidus muscle of athlete and sedentary groups might be said to result from hypertrophic effect of trainings of these athletes on the cross-sectional area of the lumbar multifidus muscle.

The Cross-Sectional Area Assessment of Pelvic Muscles Using the MRI Manual Segmentation among Patients with Low Back Pain and Healthy Subjects

“…Therefore, manual segmentation method appeared to be the most precise method for determining their volume, serving as the gold standard for segmentation [ 10 , 15 , 24 ]. Additionally, manual segmentation is a conventional method for obtaining CSA [ 10 , 11 , 12 , 13 , 14 ]. The cross-sectional area measurements allow the quantitative assessment of muscle function, which is related to muscle force generation [ 10 , 11 , 12 , 13 , 14 ].…”

“…Additionally, manual segmentation is a conventional method for obtaining CSA [ 10 , 11 , 12 , 13 , 14 ]. The cross-sectional area measurements allow the quantitative assessment of muscle function, which is related to muscle force generation [ 10 , 11 , 12 , 13 , 14 ].…”

“…Magnetic resonance imaging (MRI) is a standard method in the diagnosis of patients with symptoms of LBP but constitutes rather unproductive in patients with chronic low back pain with the exception of muscle segmentation of acquired resonance images [ 10 , 11 , 12 , 13 , 14 ]. Patients with chronic LBP present morphological changes, such as alterations in muscle activity and strength associated with variations in volume and cross-sectional area (CSA) of the lumbopelvic region.…”

“…The reduced activity caused by these morphological changes (e.g., muscle atrophy) calculated based on CSA and muscle volume may serve as an indicator of chronic LBP and can be analyzed by MRI segmentation. Additionally, a modern approach of diagnosing LBP highlights the value of muscle tissue assessment as an additional aspect that potentially facilitates pain diagnosis in this area [ 13 , 14 , 15 , 16 ]. There are several studies of successful multifidus muscle segmentation showing muscle atrophy in patients presenting symptoms of chronic low back patients [ 17 , 18 , 19 , 20 , 21 , 22 ].…”

“…Manual segmentation, which is considered the “gold standard” in medical image segmentation, allows the most precise analysis of magnetic resonance images. Moreover, cross-sectional area parameter can be obtained faster than volumetric measurement, which is especially important in time consuming manual segmentation [ 3 , 10 , 12 , 14 , 23 ].…”