The Effect of Lumbosacral Transitional Vertebrae (LSTV) on Paraspinal Muscle Volume in Patients with Low Back Pain

Ülger, Fatma; Illeez, Ozge Gulsum

doi:10.1016/j.acra.2019.09.030

Cited by 11 publications

(6 citation statements)

References 30 publications

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“…Our results also confirm the findings of Bahadir and Ulger [ 24 ] showing that an asymmetrical degree of severity of an LSTV does not lead to significant muscular asymmetry. However, patients with LSTV showed significantly less degeneration of the caudal paraspinal muscles and more degeneration of the psoas muscle and the quadratus lumborum muscle.…”

Section: Discussionsupporting

confidence: 92%

Musculature adaption in patients with lumbosacral transitional vertebrae: a matched-pair analysis of 46 patients

et al. 2021

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Objective Even though lumbosacral transitional vertebrae (LSTV) are one of the most common congenital anomalies of the spine, their effect on surrounding soft tissues is not well-studied. We therefore aimed at analyzing the association between LSTV and changes in volume, mass, symmetry, and degeneration of lumbar and trunk muscles. Materials and methods Abdomen–pelvis CT scans were analyzed in patients with LSTV and a matched control group. LSTV were classified according to the Castellvi classification. Muscles were segmented from the remaining soft tissue and their cross-sectional area and volume were examined at five defined levels. Threshold segmentation was used to differentiate between muscle fibers and fat tissue. Matched pairs were compared using Wilcoxon rank sum tests. For comparison of categorical data, chi-squared tests were performed and for associations between the degree of fusion and muscle size and degeneration, Spearman’s correlation coefficients were calculated. Inter- and intrarater reliabilities were evaluated by computing intraclass correlation coefficients. Results Forty-six patients with LSTV and 46 controls were included. Muscle volume of the paraspinal and trunk muscles was significantly lower (707.0 cm3 vs. 809.7 cm3, p < 0.001) and fatty muscle changes were significantly increased in all but the caudal paravertebral muscles of LSTV patients (M. psoas p < 0.04, M. quadratus lumborum p < 0.001, paravertebral muscles p = 0.011, M. rectus abdominis p < 0.001, M. obliquus abdominis p < 0.001). Correlations between the degree of Castellvi classification and muscle volume were significant (p = 0.001). Conclusion LSTV are associated with a reduction in muscle volume and an increase in muscle degeneration of both lumbar and trunk muscles.

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Section: Discussionsupporting

confidence: 92%

Musculature adaption in patients with lumbosacral transitional vertebrae: a matched-pair analysis of 46 patients

et al. 2021

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“…The results of the current study, demonstrating significant improvements in pain intensity, functional mobility, and overall quality of life, find resonance in the broader scope of pain management research. For instance, Ülger et al ( 2018) also emphasized the effectiveness of physiotherapy combined with minimal invasive techniques (MIT) in enhancing quality of life and reducing functional disability in geriatric patients with chronic low back pain (18). This aligns with our findings were physiotherapy, particularly with soft tissue mobilization, significantly improved patient outcomes.…”

Section: Discussionsupporting

confidence: 88%

Effectiveness of Routine Physiotherapy with and without Soft Tissue Mobilization in Improving Pain and Functional Mobility in Chronic Low Back Patient

Ashraf,

Mughal,

Khan

et al. 2023

JHRR

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Background: Chronic low back pain (CLBP) is a prevalent condition affecting a significant portion of the global population, impacting their quality of life and functional mobility. Despite various treatment modalities, the quest for the most effective intervention remains a critical area of research. Existing literature suggests varied efficacy of different physiotherapy techniques in managing CLBP. Objective: This study aimed to evaluate the effectiveness of routine physiotherapy with and without soft tissue mobilization in improving pain and functional mobility in patients with chronic low back pain. Methods: A randomized control trial was conducted with 128 participants, divided into two groups: Group A (routine physiotherapy with soft tissue mobilization) and Group B (routine physiotherapy without soft tissue mobilization). Baseline and post-treatment measurements included the Numeric Pain Rating Scale (NPRS) and Oswestry Disability Index (ODI). Participants were assessed at baseline and after a 3-month treatment period. Statistical analysis was performed using independent samples t-tests. Results: At baseline, NPRS and ODI scores showed no significant differences between the groups (NPRS: 7.4 ± 1.2 for Group A and 7.5 ± 1.3 for Group B, p=0.760; ODI: 50.3 ± 5.0 for Group A and 50.8 ± 4.8 for Group B, p=0.690). Post-treatment, Group A demonstrated significantly greater improvement (NPRS: 2.8 ± 1.1 for Group A and 4.6 ± 1.2 for Group B, p<0.001; ODI: 19.7 ± 3.5 for Group A and 29.4 ± 4.0 for Group B, p<0.001). Conclusion: The study concluded that routine physiotherapy combined with soft tissue mobilization was more effective in reducing pain and improving functional mobility in CLBP patients compared to routine physiotherapy alone. This suggests that incorporating soft tissue mobilization into standard physiotherapy regimens could be beneficial for CLBP management.

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“…These differences may result from a tissue alteration in the cadaveric study of Golubovsky et al, the analysis of asymmetric LSTV only, and an isolated view on the osteo-ligamentous structures without inclusion of the musculature in their study. At the same time, the literature reports significant muscular adaptions in patients with LSTV [ 26 , 27 ]. Recent evidence also indicates significant differences for the spinopelvic anatomy between LSTV and a control group, which might also affect the mutual interaction between the pelvis and lumbar spine [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Lumbosacral transitional vertebrae alter the distribution of lumbar mobility–Preliminary results of a radiographic evaluation

et al. 2022

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Background Lumbo-sacral transitional vertebrae (LSTV) are one of the most common congenital variances of the spine. They are associated with an increased frequency of degeneration in the cranial adjacent segment. Hypermobility and concomitant increased loads are discussed as a possible reason for segmental degeneration. We therefore examined the lumbar and segmental motion distribution in patients with LSTV with flexion-extension radiographs. Methods A retrospective study of 51 patients with osteochondrosis L5/S1 with flexion and extension radiographs was performed. Of these, 17 patients had LSTV and were matched 1:1 for age and sex with patients without LSTV out of the collective of the remaining 34 patients. The lumbar and segmental range of motion (RoM) by segmental lordosis angle and the segmental wedge angle were determined. Normal distribution of parameters was observed by Kolmogorov-Smirnov-test. Parametric data were compared by paired T-test. Non-parametric data were compared by Wilcoxon-rank-sum-test. Correlations were observed using Spearman’s Rank correlation coefficient. A p-value <0.05 was stated as statistically significant. Results Patients with LSTV had mean age of 52.2±10.9, control group of 48.9±10.3. Both groups included 7 females and 10 males. Patients with LSTV presented with reduced RoM of the lumbar spine (LSTV 37.3°±19.2°, control 52.1°±20.5°, p = 0.065), however effects were statistically insignificant. LSTV significantly decreased segmental RoM in the transitional segment (LSTV 1.8°±2.7°, control 6.7°±6.0°, p = 0.003). Lumbar motion distribution differed significantly; while RoM was decreased in the transitional segment, (LSTV 5.7%, control 16.2%, p = 0.002), the distribution of lumbar motion to the cranial adjacent segment was increased (LSTV 30.7%, control 21.6%, p = 0.007). Conclusion Patients with LSTV show a reduced RoM in the transitional segment and a significantly increased motion distribution to the cranial adjacent segment in flexion-extension radiographs. The increased proportion of mobility in the cranial adjacent segment possibly explain the higher rates of degeneration within the segment.

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The Effect of Lumbosacral Transitional Vertebrae (LSTV) on Paraspinal Muscle Volume in Patients with Low Back Pain

Cited by 11 publications

References 30 publications

Musculature adaption in patients with lumbosacral transitional vertebrae: a matched-pair analysis of 46 patients

Musculature adaption in patients with lumbosacral transitional vertebrae: a matched-pair analysis of 46 patients

Effectiveness of Routine Physiotherapy with and without Soft Tissue Mobilization in Improving Pain and Functional Mobility in Chronic Low Back Patient

Lumbosacral transitional vertebrae alter the distribution of lumbar mobility–Preliminary results of a radiographic evaluation

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