Online citations, reference lists, and bibliographies.

Lumbar Lordosis Reduction And Disc Bulge May Correlate With Multifidus Muscle Fatty Infiltration In Patients With Single-segment Degenerative Lumbar Spinal Stenosis

Youwen Liu, Yu-zeng Liu, Yong Hai, Guan Li, Yunsheng Wang
Published 2020 · Medicine
Cite This
Download PDF
Analyze on Scholarcy
Share
OBJECTIVES To investigate the correlation between fatty infiltration in the multifidus muscle related to the involved nerve root and structural parameters associated with stenosis in patients with degenerative lumbar spinal stenosis (DLSS). PATIENTS AND METHODS Sixty-four patients with single-segment DLSS at L4-5 were retrospectively enrolled. The fatty infiltration rate (FIR) of the multifidus muscle at L5-S1, lumbar lordosis and the cross-sectional area (CSA) of the structural parameters at L4-5, such as dural sac, disc bulge, ligamentum flava and vertebral body of L5 were measured on magnetic resonance images using ImageJ software. All enrolled patients were divided into an FIR < 25 % group and an FIR ≥ 25 % group according to the FIR of the multifidus muscle at L5-S1. The propensity scores matching and adjustment of potential covariates were performed to reduce the confounding bias between the two groups. RESULTS Lumbar lordosis in the FIR ≥ 25 % group was significantly lower than that in the FIR<25 % group in both cohorts. The mean differences in lumbar lordosis of 14.16 degrees between the two groups in the complete cohort and of 14.23 degrees in the matched cohort remained significant after adjustment. The disc bulge CSA/ vertebral body CSA in the FIR ≥ 25 % group was greater than that in the FIR<25 % group in both cohorts. The mean differences in the disc bulge CSA/ vertebral body CSA between the two groups of 0.67 in the complete cohort and 0.96 in the matched cohort were statistically significant after adjustment. There was no significant difference in the dural sac CSA/ vertebral body CSA and ligamentum flava CSA/ vertebral body CSA between the two groups in either cohort regardless of adjustment. Logistic regression analysis for FIR ≥ 25 % in the multifidus muscle at L5-S1 exhibited that the disc bulge CSA/ vertebral body CSA were independent risk factors with odds ratio (OR) of 8.52, while lumbar lordosis were independent protective factors (OR = 0.72). CONCLUSIONS The disc bulge at the stenosis segment and lumbar lordosis reduction may be correlated with fatty infiltration in the multifidus muscles at L5-S1 in patients with L4-5 single-segment DLSS.
This paper references
10.1016/j.math.2011.01.010
Lumbar spinal stenosis-diagnosis and management of the aging spine.
Karen Maloney Backstrom (2011)
The human lumbar dorsal rami.
Nikolai Bogduk (1982)
10.1097/00007632-199712150-00021
Dynamic Effects on the Lumbar Spinal Canal: Axially Loaded CT‐Myelography and MRI in Patients With Sciatica and/or Neurogenic Claudication
Jan A. G. Willen (1997)
10.1007/s00586-015-4014-y
Cross-sectional area of human trunk paraspinal muscles before and after posterior lumbar surgery using magnetic resonance imaging
Mohammad Sadegh Ghiasi (2015)
10.1007/s00223-006-0041-3
Genetic and Environmental Correlations between Bone Geometric Parameters and Body Compositions
Xiao Sun (2006)
10.1016/j.pmr.2010.12.002
The role of core stabilization in lumbosacral radiculopathy.
David Jr. Kennedy (2011)
The topographical anatomy of the lumbar epidural space.
Ian G. Parkin (1985)
10.1056/NEJMoa1513721
A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis.
Peter Försth (2016)
10.1016/0268-0033(86)90146-4
The morphology of the human lumbar multifidus.
J E Macintosh (1986)
10.1016/j.clineuro.2016.03.005
Comparison of multifidus muscle atrophy after posterior lumbar interbody fusion with conventional and cortical bone trajectory
Che-Wei Hung (2016)
10.1007/s00586-016-4889-2
Comparison of MRI-defined back muscles volume between patients with ankylosing spondylitis and control patients with chronic back pain: age and spinopelvic alignment matched study
Doo Hee Bok (2016)
10.3171/2009.7.SPINE08448
Morphological changes of the multifidus muscle in patients with symptomatic lumbar disc herniation.
Joerg Franke (2009)
10.1111/joa.12047
The relationship between sagittal curvature and extensor muscle volume in the lumbar spine.
Judith R Meakin (2013)
10.1002/mus.24759
Paraspinal muscle denervation and balance impairment in lumbar spinal stenosis.
Emel Ece Ozcan-Eksi (2016)
10.1097/00007632-198107000-00011
Biomechanics of Lumbosacral Dural Sac: A Study of Flexion-Extension Myelography
Lourens Penning (1981)
10.1016/j.pain.2007.01.012
The impact of chronic low back pain on older adults: A comparative study of patients and controls
Thomas E. Rudy (2007)
10.1097/00007632-198409000-00011
Pressure changes within the cauda equina following constriction of the dural sac. An in vitro experimental study.
N S Schönström (1984)
10.1097/00007632-200008150-00002
Anatomic and Biomechanical Analysis of the Lower Lumbar Foraminal Ligaments
Paul Francis Michael Grimes (2000)
10.1227/NEU.0000000000001269
The Effect of Lumbar Spinal Muscle on Spinal Sagittal Alignment: Evaluating Muscle Quantity and Quality.
Hyo Sub Jun (2016)
10.1007/BF00576316
Lumbar spinal stenosis.
Kern Singh (2008)
10.4085/1062-6050-49.3.61
Lower extremity fatigue, sex, and landing performance in a population with recurrent low back pain.
Ram Haddas (2015)
10.1007/s00256-015-2252-z
Lumbar multifidus muscle changes in unilateral lumbar disc herniation using magnetic resonance imaging
Naime Altınkaya (2015)
10.1007/s00256-018-2880-1
Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients
Julio Urrutia (2018)
10.1097/01.brs.0000248453.51165.0b
Rapid Atrophy of the Lumbar Multifidus Follows Experimental Disc or Nerve Root Injury
Paul William Hodges (2006)
10.1007/s00586-009-0919-7
The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum
Tommy Hansson (2009)
10.2106/JBJS.N.00313
Effectiveness of surgery for lumbar stenosis and degenerative spondylolisthesis in the octogenarian population: analysis of the Spine Patient Outcomes Research Trial (SPORT) data.
Jeffrey A. Rihn (2015)
10.1097/BRS.0b013e3181bfca15
Ligamentum Flavum Thickness in Normal and Stenotic Lumbar Spines
Janan Abbas (2010)



Semantic Scholar Logo Some data provided by SemanticScholar