Research Paraspinal Muscles In Changes In Lumbar Degenerative Diseases

PURPOSE:To compare changes of lumbar paraspinal muscles (psoas, erector spinae, multifidus) with MRI in lumbar degenerative diseases and low back pain patients, to investigate the role of paraspinal muscles changes in the progress of lumbar degenerative diseases. To investigate the change of muscle strength of paraspinal muscles and the relationship between muscle strength and radiological change.METHODS:The study group comprised LDD patients (27patients,12of them were women, aged45-85years, mean64years) and a control group with LBP (11patients,3of them were women, aged45-74years, mean54years). The cross-sectional areas (CSA) of psoas, erector spinae, multifidus, and disc, were measured at the L4-L5level using magnetic resonance imaging (MRI). Lumbar muscularity was expressed as three ratios:the ratio between CSA of psoas, erector spinae, multifidus and CSA of disc (PS/disc, ES/disc, MF/disc).5patients(3LDD patients,2control group) participated lumbar muscles strength tests.RESULTS:The CSAs of disc at the L4-5level were found to have no significant difference(p>0.05) between LDD patients and the control group. Lumbar muscularity was found to be significantly smaller in LDD patients than those of control group. No meaningful relationship between CSA of Multifidus and force of rotation when sitting was found in the muscle strength tests.CONCLUSIONS:The paraspinal muscles atrophy was significant and happened earlier than lumbar disc degeneration. Acquiring MRI to evaluate the paraspinal muscles would be of great help to give more confident diagnosis of lumbar degenerative diseases at early stage and to predict its progression. Muscle strength tests along with radiological tests might be a new helpful investigating method in the future and a great help to conduct nonoperative therapy of lumbar degenerative diseases.