Year 2021, Volume 7 , Issue 4, Pages 409 - 416 2021-07-04

Magnetic resonance imaging changes in multifidus and psoas muscles in patients with lumbar spinal stenosis

Gökhan ÇAVUŞ [1] , Yeliz ÇAVUŞ [2]


Objectives: The aim of this study is to evaluate the relationship between the spinal canal cross-sectional area (SCCSA) at the stenosis level, the cross-sectional areas of the multifidus (MF) muscle at the L3-S1 levels, and the cross-sectional areas of the psoas muscle (PSCSA) at the L3 level in patients with nerve compression due to lumbar spinal stenosis.

Methods: A total of 280 patients were included in the study, 140 in the control group and 140 with lumbar spinal stenosis that had been detected with magnetic resonance imaging (MRI). The patients' ages, gender, SCCSA at the level of stenosis, PSCSA at L3 level, MFCSA at L3-S1 levels, and degrees of atrophy caused by multifidus muscle fatty degeneration were evaluated and compared with the control group whether the comparison was statistically significant or not.

Results: PSCSA values at the L3 level and MFCSA at the L3-4 level (r=0.555, p < 0.01), MFCSA at the L4-L5 level (r=0.559, p < 0.01), and MFCSA at the L5-S1 level (r=0.429, p < 0.01) were found to have a statistically significant positive correlation. In addition, MFCSA at the L3-4 level (p < 0.001), MFCSA at the L4-5 level (p < 0.001), MFCSA at the L5-S1 level (p < 0.001),the L3-L4 SCCSA (p < 0.001), and the L4-L5 SCCSA (p < 0.001) mean values were found to be statistically significantly lower than the mean of the cases in the control group.

Conclusions: Compared to the control group, a significant correlation was found with a decrease in the CSA of the multifidus muscle and the presence of fatty degeneration of the multifidus muscle in patients with spinal stenosis. However, in the CSA of the psoas muscle at the L3 level, it was found that there was no correlation between patients with spinal stenosis and the control group.

Fatty degeneration, stenosis, multifidus, spinal, psoas, cross-sectional area
  • 1. Sullivan MS. Back support mechanisms during manual lifting. Phys Ther 1989;69:38-45.
  • 2. Kader DF, Wardlaw D, Smith FW. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol 2000;55:145-9.
  • 3. Farshad M, Gerber C, Farshad-Amacker NA, Dietrich TJ, Laufer-Molnar V, Min K. Asymmetry of the multifidus muscle in lumbar radicular nerve compression. Skeletal Radiol 2014;43:49-53.
  • 4. Boissière L, Moal B, Gille O, De-Roquefeuil E, Durieux M, Obeid I, et al. Lumbar spinal muscles and spinal canal study by MRI three-dimensional reconstruction in adult lumbar spinal stenosis. Orthop Traumatol Surg Res 2017;103:279-83.
  • 5. Saifuddin A. The imaging of lumbar spinal stenosis. Clin Radiol 2000;55:581-94.
  • 6. An SJ, Mun JU, Kang KN, Kim YU. Superior articular process cross-sectional area is a new sensitive parameter for the diagnosis of lumbar central canal spinal stenosis. Clin Interv Aging 2018;13:1763-7.
  • 7. Hicks GE, Simonsick EM, Harris TB, Newman AB, Weiner DK, Nevitt MA, et al. Cross-sectional associations between trunk muscle composition, back pain, and physical function in the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 2005;60:882-7.
  • 8. Kamath S, Venkatanarasimha N, Walsh MA, Hughes PM. MRI appearance of muscle denervation. Skeletal Radiol 2008;37:397-404.
  • 9. Hildebrandt M, Fankhauser G, Meichtry A, Luomajoki H. Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain. BMC Musculoskelet Disord 2017;18:1-9.
  • 10. Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine (Phila Pa 1976) 2004;29:515-9.
  • 11. De Sèze MP, Guérin P, Gille O, Jolivet E, Skalli W. Reliability of magnetic resonance imaging measurements of the cross-sectional area of the muscle contractile and non-contractile components. Surg Radiol Anat 2011;33:735-41.
  • 12. Yagi M, Hosogane N, Watanabe K, Asazuma T, Matsumoto M. The paravertebral muscle and psoas for the maintenance of global spinal alignment in patient with degenerative lumbar scoliosis. Spine J 2016;16:451-8.
  • 13. Takayama K, Kita T, Nakamura H, Kanematsu F, Yasunami T, Sakanaka H, et al. New predictive index for lumbar paraspinal muscle degeneration associated with aging. Spine (Phila Pa 1976) 2016;41:E84-E90.
  • 14. Sasaki T, Yoshimura N, Hashizume H, Yamada H, Oka H, Matsudaira K, et al. MRI-defined paraspinal muscle morphology in Japanese population: The Wakayama Spine Study. PLoS One 2017;12:1-15.
  • 15. Zhao WP, Kawaguchi Y, Matsui H, Kanamori M, Kimura T. Histochemistry and morphology of the multifidus muscle in lumbar disc herniation: Comparative study between diseased and normal sides. Spine (Phila Pa 1976) 2000;25:2191-9.
  • 16. Yoshihara K, Shirai Y, Nakayama Y, Uesaka S. Histochemical changes in the multifidus muscle in patients with lumbar intervertebral disc herniation. Spine (Phila Pa 1976) 2001;26:622-6.
  • 17. Hodges P, Holm AK, Hansson T, Holm S. Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine (Phila Pa 1976) 2006;31:2926-33.
Primary Language en
Subjects Surgery
Journal Section Original Articles
Authors

Orcid: 0000-0001-7078-2501
Author: Gökhan ÇAVUŞ (Primary Author)
Institution: Department of Neurosurgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0001-5249-7598
Author: Yeliz ÇAVUŞ
Institution: Department of Radiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Dates

Application Date : May 17, 2021
Acceptance Date : June 12, 2021
Publication Date : July 4, 2021

EndNote %0 The European Research Journal Magnetic resonance imaging changes in multifidus and psoas muscles in patients with lumbar spinal stenosis %A Gökhan Çavuş , Yeliz Çavuş %T Magnetic resonance imaging changes in multifidus and psoas muscles in patients with lumbar spinal stenosis %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 4 %R doi: 10.18621/eurj.937447 %U 10.18621/eurj.937447