The Clinical Study Of Paravertebral Muscle Area And Lumbar Facet Joint Angle In Patients With Degenerative Lumbar Spinal Stenosis

BackgroundDegenerative lumbar spinal stenosis is a common clinical disease,which is common cause of low back and leg pain.Due to the complexity of imaging findings and etiology,the current research on the change of cross-sectional area of paravertebral muscles is controversial.Meanwhile,There are few studies on the imaging of lumbar facet joint degeneration,which needs to be further explored.ObjectiveWe used MRI to observe the imaging changes of the lumbar facet joint angle and paraspinal muscle cross-sectional area in patients with degenerative lumbar spinal stenosis,And analyze the relationship between the cross-sectional area and the angle.The purpose is to provide a theoretical basis for the Chinese medicine "JIN ROU GU ZHENG" and the clinicians to deeply understand the influence of paravertebral structures on lumbar diseases.MethodsRetrospective analysis of 80 cases of degenerative lumbar spinal stenosis in the inpatient department and outpatient department of Fangcun Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from June 2016 to December 2017 as a case group.During the same period,80 patients with non-degenerative lumbar disease treated as a control group.Through observation of the cross section of the MRI T2WI,the bilateral lumbar facet joint angle and multi-fissure muscle and erector spinae,psoas muscle cross-sectional area were observed and measured in the L4/5 and L5/S1 segment.To study the imaging changes of facet joint angle and cross-sectional area of bilateral lumbar spine in different segments,and to analyze the relationship between them.ResultsThere were no significant differences in the basic data(age,gender,body mass index)between the two groups(P>0.05),which were comparable.In L4/5 and L5/S1 segments,the mean cross-sectional area of left and right polyfid muscles,erector spine muscles and psoas major muscles was significantly different between the two groups(P<0.05).Moreover,the mean values of cross-sectional areas in different sections of the two groups were compared,and the difference was statistically significant(P<0.05).In two groups,the mean area of fat infiltration and the FD value of the bilateral multifidus muscles,the erector spinae,and the psoas muscle were compared,the difference was statistically significant(P<0.05).Besides,in the same muscle of different segments,the mean difference of fat infiltration area between the two groups was statistically significant(P<0.05).In the L4/5 segment,there was a significant difference in the mean value of bilateral lumbar facet joint angle between the two groups(P<0.05).However,in the L5/S1 segment,the difference was not statistically significant(P>0.05).In the same segment,there was no correlation between the mean cross-sectional area of the bilateral psoas muscles and the mean bilateral lumbar facet joint angles in the DLSS group(P>0.05)·ConclusionLumbar spine multifidus and erector spinae with different degrees of fat infiltration is one of the normal physiological degeneration of the body.In patients with lumbar spinal stenosis,the area of multifidus and erector spinae is reduced,degeneration and atrophy are obvious,and fat infiltration and degeneration are severe.However,the psoas major muscle compensatory hypertrophy,the lumbar facet joint angle is reduced,and the sagittal position is the MRI imaging feature.Then,there was no correlation between the cross-sectional area of the multifidus muscle and the erector spinae and the angle of the facet joint of the lumbar spine.The imaging findings of degenerative changes of paravertebral muscles provide a basis for clinicians to correctly and deeply understand the influence of paravertebral structures on lumbar spinal stenosis.