Spinal muscle evaluation in healthy individuals and low-back-pain patients: a literature review

Demoulin, Christophe; Crielaard, Jean-Michel; Vanderthommen, Marc

doi:10.1016/j.jbspin.2006.02.013

Cited by 128 publications

(104 citation statements)

References 55 publications

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“…In addition to a strong association between low back pain and paraspinal muscle atrophy, a significant correlation exists between low back pain and back muscle fatigue, as detected by electromyography performed in a study by Dedering et al [18,19] and Demoulin et al [20]. These observations suggest a positive relationship between paraspinal muscle atrophy and muscular fatigue.…”

Section: Discussionmentioning

confidence: 89%

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

et al. 2012

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Introduction The conventional open pedicle screw fusion (PSF) requires an extensive detachment of the paraspinal muscle from the posterior aspect of the lumbar spine, which can cause muscle injury and subsequently lead to ''approachrelated morbidity''. The spinous process-splitting (SPS) approach for decompression, unilateral laminotomy for bilateral decompression, and the Wiltse approach for pedicle screw insertion are considered to be less invasive to the paraspinal musculature. We investigated whether SPS open PSF combined with the abovementioned techniques attenuates the paraspinal muscle damage and yields favorable clinical results, including alleviation in the low back discomfort, in comparison to the conventional open PSF. Methods We studied 53 patients who underwent singlelevel PSF for the treatment of degenerative spondylolisthesis (27 patients underwent SPS open PSF and the other 26 underwent the conventional open PSF). The clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score, the Roland-Morris disability questionnaire (RDQ), and the visual analog scale (VAS) for low back pain and low back discomfort (heavy feeling or stiffness). Postoperative multifidus (MF) atrophy was evaluated using MRI. Follow-up examinations were performed at 1 and 3 years after the surgery.Results Although there was no significant difference in the JOA and RDQ score between the two groups, the VAS score for low back pain and discomfort after the surgery were significantly lower in the SPS open PSF group than in the conventional open PSF group. The extent of MF atrophy after SPS open PSF was reduced more significantly than after the conventional open PSF during the follow-up. The MF atrophy ratio was found to correlate with low back discomfort at the 1-year follow-up examination. ConclusionIn conclusion, SPS open PSF was less damaging to the paraspinal muscle than the conventional open PSF and had a significant clinical effect, reducing low back discomfort over 1 year after the surgery.

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Section: Discussionmentioning

confidence: 89%

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

et al. 2012

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“…Although the lack of correlation between pathology and pain is largely argued to be due to the multifactorial nature of the report of pain (including other biologic, psychologic and social factors); it is also possible that the poor relationship is explained by other factors that have not been evaluated in a routine CT evaluation. Among such factors are degenerative changes in facet joints [25], ligamentous damage [43] and changes (traumatic or degenerative) in paraspinal muscles [7,37].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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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.

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“…В нескольких исследованиях утверждается, что отсутствие связи между радиографической картиной и болью в основном обу-словлено многофакторным характером боли (включая различные биологические, психологические и социаль-ные факторы). Также возможно, что низкая ассоциация обусловлена факторами, которые не были оценены с помощью рутинной визуализации, то есть дегенератив-ными изменениями в фасетчатых суставах [16,17], свя-зочным повреждением [18] и изменениями (травматиче-скими или дегенеративными) в параспинальных мышцах [19][20][21][22]. Также в исследованиях сообщалось об атрофии и других аномалиях параспинальных мышц у 20-60% лиц с хронической БНЧС [23,24].…”

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“…[25] МРТ-исследования показали, что жировая инфильтрация в поясничной области сильно связана с БНЧС у взрослых. Также было обнаружено, что хроническая БНЧС связана с уменьшением плотности мышечных волокон [21].…”

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Some of the Pain Features at the Bottom of the Back

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Spinal muscle evaluation in healthy individuals and low-back-pain patients: a literature review

Cited by 128 publications

References 55 publications

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

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

Some of the Pain Features at the Bottom of the Back

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