Research Progress on the Mechanism of Lumbarmultifidus Injury and Degeneration

Abstract

This review summarizes recent research progress in the clinical features, image manifestations, and pathological mechanism of multifidus injury. After a brief introduction to the fiber classification, innervation, blood supply, and multifidus function, some factors of multifidus injury, consisting of denervation, intraoperative incision selection and traction, and lumbar degenerative disease are overviewed. In addition, the clinical index of multifidus injury including myoglobin, creatine kinase, IL-6, C-reactive protein, the cross-sectional area of multifidus, the degree of fat infiltration, and intraoperative biopsy are summarized. Furthermore, we recommend that patients with chronic low back pain should take the long-term exercise of lumbodorsal muscles. Finally, some remaining issues, including external fixation and the imaging quantitative evaluation criteria of multifidus, need to be further explored in the future.

Magnetic Resonance Imaging Evaluation of Multifidus Muscle in Patients with Low Back Pain after Microlumbar Discectomy Surgery

“…This pain leads to reflex inhibition of the MFM, followed by further atrophy and fatty replacement of the muscle. It's important to note that even if the LBP is alleviated, normal MFM function may not resume, and decreased MFM function can contribute to recurring LBP [48,49]. To prevent further atrophy of the MFM and progressive degeneration, patients with chronic LBP and those who have undergone lumbar surgery should engage in long-term rehabilitation exercises to strengthen the lumbar muscles.…”

Facet overhang: A novel parameter in the pathophysiology of multifidus muscle atrophy

“…Lastly, high concentrations of proinflammatory mediators have been detected in and are released from facet joint tissues in degenerative spinal disorders (Igarashi et al, 2004 ; Igarashi et al, 2007 ; Sugimoto et al, 2019 ). As such, deep part of the multifidus atrophy may also result from extension of local inflammation (Wang et al, 2021 ).…”

Research Progress on the Effect of Unilateral Biportal Endoscopic on Lumbar Stability in the Treatment of Lumbar Disc Herniation

“…The lumbar multifidus muscle is enveloped within the muscle sheath formed by the superficial and middle layers of the thoracolumbar fascia. The longest muscle, spinous processes, and vertebral lamina are located on the lateral, medial, and ventral sides of the multifidus muscle [34].The multifidus muscle (LMM) specifically functions to maintain the stability of the spinal segments, preserve the physiological lordosis of the lumbar spine, control the movement of the facet joints, and regulate the distribution of intervertebral loads and pressure. Kuan et al [35]compared a trunk musculoskeletal model based on 250 healthy adults with and without the multifidus muscle.…”