Multifidus Degeneration, A New Risk Factor for Lumbar Spinal Stenosis: A Case–Control Study

Jiang, Jinbo; Wang, Haibin; Wang, Liang; Zhang, Bangke; Guo, Qunfeng; Yuan, Wen; Lü, Xiaoying

doi:10.1016/j.wneu.2016.11.142

Cited by 30 publications

(31 citation statements)

References 17 publications

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“… ▪ NB: the lower fat content in the stenosis group may be the result of the muscles being measured above the level of reported stenosis. ○ [ 53 ]: assessed fat infiltration with MRI at the level of stenosis, with a greater fat infiltration ratio in the stenosis group (N = 40; P = 0.004). • 3 studies assessed the relationship of stenosis to muscle atrophy [ 20 , 52 , 53 ]: ○ [ 20 ]: reported a reduction in FCSA of LMM between stenosis and healthy control groups ( P = 0.04), but not stenosis and LBP groups.…”

Section: Resultsmentioning

confidence: 99%

“… ○ [ 53 ]: assessed fat infiltration with MRI at the level of stenosis, with a greater fat infiltration ratio in the stenosis group (N = 40; P = 0.004). • 3 studies assessed the relationship of stenosis to muscle atrophy [ 20 , 52 , 53 ]: ○ [ 20 ]: reported a reduction in FCSA of LMM between stenosis and healthy control groups ( P = 0.04), but not stenosis and LBP groups. ○ [ 52 ]: demonstrated greater FCSA of the ESM in male ( P = 0.011) and female ( P = 0.014) stenosis patients, and PMM in male stenosis patients ( P = 0.042), but no significant difference for the LMM.…”

Section: Resultsmentioning

confidence: 99%

“…NB: acquired measurements at L3, which could account for conflicting results with other studies. ○ [ 53 ]: evaluated muscle asymmetry and TCSA measures of the LMM at L4/5;with greater asymmetry ( P = 0.006) and lower TCSA:body ratios ( P = 0.006) reported in the stenosis group. • 1 study used MR spectroscopy to assess extramyocellular lipids (EMCL) and intramyocelluar lipds (IMCL) [ 54 ]: ○ when assessing EMCL content (i.e, the fat tissue deposits visible on standard MR imaging), no difference was found between the stenosis and CLBP groups; this is in agreement with the study by Yarjanian above [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies used the same CT data set to assess fatty infiltration of the LMM and ESM in a general volunteer population [ 31 , 32 ]. The remaining studies evaluated patients with clinical and/or imaging findings consistent with stenosis; one used CT [ 52 ], two used MRI [ 20 , 53 ], and one used MR spectroscopy [ 54 ]. Of these latter four studies, one compared spinal stenosis patients to LBP patients without spinal stenosis as well as asymptomatic volunteers [ 20 ], one compared stenosis to chronic LBP patients only [ 54 ], while to remaining two studies compared patients with and without stenosis only.…”

Section: Resultsmentioning

confidence: 99%

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Relationships between paraspinal muscle morphology and neurocompressive conditions of the lumbar spine: a systematic review with meta-analysis

Cooley

Walker

Ardakani

et al. 2018

BMC Musculoskelet Disord

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BackgroundIndividual study results have demonstrated unclear relationships between neurocompressive disorders and paraspinal muscle morphology. This systematic review aimed to synthesize current evidence regarding the relationship lumbar neurocompressive disorders may have with lumbar paraspinal muscle morphology.MethodsSearches were conducted in seven databases from inception through October 2017. Observational studies with control or comparison groups comparing herniations, facet degeneration, or canal stenosis to changes in imaging or biopsy-identified lumbar paraspinal muscle morphology were included. Data extraction and risk of bias assessment were performed by review author pairs independent of one another. Morphological differences between individuals with and without neurocompressive disorders were compared qualitatively, and where possible, standardised mean differences were obtained.ResultsTwenty-eight studies were included. Lumbar multifidus fiber diameter was smaller on the side of and below herniation for type I [SMD: −0.40 (95% CI = −0.70, −0.09) and type II fibers [SMD: −0.38 (95% CI = −0.69, −0.06)] compared to the unaffected side. The distribution of type I fibers was greater on the herniation side [SMD: 0.43 (95% CI = 0.03, 0.82)]. Qualitatively, two studies assessing small angular fiber frequency and fiber type groupings demonstrated increases in these parameters below the herniation level. For diagnostic imaging meta-analyses, there were no consistent differences across the various assessment types for any paraspinal muscle groups when patients with herniation served as their own control. However, qualitative synthesis of between-group comparisons reported greater multifidus and erector spinae muscle atrophy or fat infiltration among patients with disc herniation and radiculopathy in four of six studies, and increased fatty infiltration in paraspinal muscles with higher grades of facet joint degeneration in four of five studies. Conflicting outcomes and variations in study methodology precluded a clear conclusion for canal stenosis.ConclusionsBased on mixed levels of risk of bias data, in patients with chronic radiculopathy, disc herniation and severe facet degeneration were associated with altered paraspinal muscle morphology at or below the pathology level. As the variability of study quality and heterogeneous approaches utilized to assess muscle morphology challenged comparison across studies, we provide recommendations to promote uniform measurement techniques for future studies.Trial registrationPROSPERO 2015: CRD42015012985Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2266-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Relationships between paraspinal muscle morphology and neurocompressive conditions of the lumbar spine: a systematic review with meta-analysis

Cooley

Walker

Ardakani

et al. 2018

BMC Musculoskelet Disord

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“…This can lead to an increase in the use of health services. Moreover, worsening of the spinal condition of the patient can occur due to other diseases associated with aging [1,7,8]. According to Iran's national census of 2016, individuals over 65 years of age constituted about 6.09% of the total population in Iran and over 8.4% of the population in Tehran.…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes for lumbar spinal canal stenosis in elderly patients

et al. 2018

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An Open Access PublisherPurpose of the study: To understand surgical outcomes, based on standardized tools, after surgery of lumbar spinal canal stenosis in patients aged 65 years and older. Methods: A cross-sectional study was undertaken in 58 elderly patients before and after surgery. Demographic data, procedures, perioperative comorbidities, preoperative and postoperative pain intensity, primary activities of daily living, quality of life, and fear avoidance were collected at baseline. All patients were followed up to 6 and 12 months after operation. Results: Following surgery, there was a significant reduction in the VAS scale (for pain severity) and fear avoidance beliefs (FAB) questionnaire scale (P<0.001), and a significant increase in the 36-Item Short Form Health Survey (SF-36) index and the Barthel Index for Activities of Daily Living (ADL), which assesses functional independence) (P<0.001). Implication: The present study suggests that surgery in elderly patients is effective for the treatment of spinal stenosis, in those patients who did not respond well to conservative treatment. Abstract

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Editorial for “Evaluation of the Reproducibility of MR Elastography Measurements of the Lumbar Back Muscles”

Spinnato

2023

Magnetic Resonance Imaging

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Multifidus Degeneration, A New Risk Factor for Lumbar Spinal Stenosis: A Case–Control Study

Cited by 30 publications

References 17 publications

Relationships between paraspinal muscle morphology and neurocompressive conditions of the lumbar spine: a systematic review with meta-analysis

Relationships between paraspinal muscle morphology and neurocompressive conditions of the lumbar spine: a systematic review with meta-analysis

Surgical outcomes for lumbar spinal canal stenosis in elderly patients

Editorial for “Evaluation of the Reproducibility of MR Elastography Measurements of the Lumbar Back Muscles”

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