Degeneration Of Multifidus Muscle In Adult Patients With Low Back Pain By Magnetic Resonance Imaging

Background:Low back pain is one of the most common physical complaints worldwide,which has seriously impaired social productivity and increased the medical resource expendence. The cause of low back pain has been widely researched by many experts and doctors, they found that low back pain not only attribute to pathological factors,such as,lumbar disc degeneration, lumbar instability, but also refer to genetic factors, age, gender, occupation, and social psychological factors.The paraspinal muscles are responsible for providing dynamic stability to the spine, especially the multifidus muscles, which are uniquely designed to stabilize and produce large forces.The mulitifidus is the largest one of paraspinal muscles, and this muscle fiber is short and toughness, which play a vital role in maintaining the lumbar stability.The atrophy has shown in lumbar muscles with low back pain patients. Because of a few studies are the small sample, we were not able to perform a metaregression to quantitatively evaluate the effects of blinding on the results of the studies.Objective:The purpose of this study was to discover the rule of degenerative changes of mulitifidus muscle in patients with LBP, this study used MRI as the imaging modality.Subjects and methods:There are280patients MRI inspectors with low back pain during January2011-December2013. The age of18and above, according to the different gender in two groups, each group separately since18years, increasing10years is divided into subgroups, such as:18-27,28-37,38-47,48-57,58-67,68-77years groups, more than78-year-old group, seven subgroup, each group is made up of20patients, male140, female140.Results:1, mulitifidus muscle thickness is greater in male group compare with the corresponding age women;2, the degree of muscular fatty infiltration were positively associated with age;3, There is no significant statistical difference in the mlitifidus muscle cross-sectional area for male before the age of58, the same as before48for female, but men after58and women after48, muscle fiber atrophy, cross-sectional area and fatty infiltration are age-related changing.4, The distance from mlitifidus muscle edge to the center of spine presents normal distribution, there was no significant difference in the same segmental level between men and women, also no significant differences between each group.Conclusions:the degeneration of multifidus appeared earlier in female patient than the male, primary degenerative MRI imaging features:1, muscle fiber atrophy, corresponding to the image of muscle bundle of thinner, narrow, smaller;2, organization of muscle fatty infiltration, characterized by muscular clearance dot, line, pinnate or grid change.the distance of multifibus muscle to the spinous midline accords with normal distribution, the lumbar farther the distance, with lumbar segmental spacing gradually narrowed, the rose in relatively close to the spine on lumbar line, this provide anatomical basis for clinical surgery.