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

Abstract

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.

Behavior of the Lumbar Multifidus During Lower Extremity Movements in People with Recurrent Low Back Pain During Symptom Remission

“…45 The increased LM percentage thickness change was also not expected based on other data demonstrating decreased static LM CSA using ultrasound imaging in people with acute and subacute LBP, 8,10 decreased LM CSA, 12 reduced LM activity in a porcine model, 15 delayed activity of the deep fibers of the LM in people during remission from recurrent LBP using intramuscular electromyography, 31 and fatty infiltration into LM using computed tomography scanning 5 and magnetic resonance imaging in people with chronic LBP. 19,24 However, differential changes in the activity of the deep and superficial fibers of the LM in people with a history of recurrent LBP may be one possible mechanism to explain this observed increased LM percentage thickness change during the PSLR. The current findings are consistent with EMG data obtained with selective intramuscular recording techniques that show greater superficial LM EMG amplitude and reduced deep LM EMG amplitude in people with recurrent LBP (despite symptom remission) than in healthy participants, during predictable and self-initiated trunk loading.…”

Das sensomotorische System und die Auswirkungen der Physiologie des Alterungsprozesses

“…Insbesondere ist die Stützsensomotorik betroffen, die verantwortlich ist für die aktive statische und/oder dynamische Sicherung und Stabilisierung von Haltung, Stellung und Gleichgewicht mithilfe der spinalen und supraspinalen Reflexe und Automatismen. Die Verknüpfung von intervertebraler Degeneration und der Atrophie der paraspinalen Muskulatur ist belegt, wenngleich es zum Kreuzschmerz keine evidente Verbindung gibt [15]. Chronischer Kreuzschmerz allerdings, egal welcher Ursache, führt zu einer zentralen Sensibilisierung.…”

3D false color computed tomography for diagnosis and follow-up of permanent denervated human muscles submitted to home-based Functional Electrical Stimulation

“…to identify a panel of the most descriptive presentations. Additional analytical methods of muscle tissue volume and density may be found in other published clinical imaging articles, [74][75] in studies of aging 76 and are described in detail in other reviews and articles of the EJTM Special "News on clinical imaging of muscle tissue". [77][78][79][80][81] …”