LOMBER DİSK HERNİASYONU İLE PARASPİNAL KASLARIN VOLÜMÜ VE YAĞLANMA DERECESİ ARASINDAKİ İLİŞKİNİN DEĞERLENDİRİLMESİ

Year 2016, Volume: 17 Issue: 4, 94 - 100, 20.10.2016

Ümmühan Özelçi Ayşegül Sarsılmaz

https://doi.org/10.18229/kocatepetip.278468

Abstract

Introduction: We analyzed the correlation between disc herniation and the degree of adiposity and atrophy in paraspinal muscles (multifidus, psoas major, and erector spinae) of patients with chronic low back pain.

Materials and methods: We retrospectively evaluated patients with a chronic low back pain diagnosis who were examined by lumbar magnetic resonance imaging at our clinic between September 2008 and February 2009. The patient group included 120 subjects of both genders with disc herniation ranging in age from 20 to 70 years; 120 subjects of both genders without disc herniation aged 20–70 years were designated as the control group. The patient and control groups were divided into subgroups as aged 20–30, 31–40, 41–50, and ≥51 years. Adiposity and muscle atrophy of paraspinal muscles (multifidus, psoas major, and erector spinae) were examined in all groups. Patients were also evaluated in terms of the number of disc herniations, end-plate and facet degeneration, and transitional anomalies.

Results: The average value was significantly lower in the patient group for the multifidus mean muscle area com-pared to the control group in those aged ≥51 years (p=0.005). No significant differences between the patient and the control groups were observed for psoas major and erector spinae muscle areas in all age groups (p > 0.05).A significant difference was established in terms of mean multifidus and psoas muscle areas among the age groups (p = 0.005); however, no significant difference was found for mean erector spinae muscle area. A significant correlation was observed for disc herniation and facet joint degeneration in the 31–40-year-old group. Also, there was significant correlation with end-plate degene-ration and disc herniation in the 20–30-year-old group. No difference was detected for the mean muscle areas according to the number of disc herniations. A significant difference in the degree of adiposity was found between the patient and control groups (p < 0.05).

Conclusion: We identified a significant correlation between disc herniation and adiposity in paravertebral muscles of patients with chronic low back pain, and a significant correlation between disc herniation and severe atrophy only in the multifidus muscle in late middle-aged patients (≥51 years). However, muscle atrophy was not observed in the erector spinae muscle due to aging in the patient and control groups, whereas muscle atrophy developed in both the multifidus and psoas major muscles due to aging. No correlation was found betwee

Keywords

lumbar disc herniation, paraspinal muscle, atrophy, adiposity, magnetic resonance imaging

References

• Smeets RJ, Wade D, Hidding A, Van Leeuwen PJ, Vlaeyen JW, Knottnerus JA. The association of physical deconditioning and chronic low back pain: a hypothesis-oriented systematic review. Disabil Rehabil 2006;28:673-93.
• Mannion AF, Dvorak J. The role of paraspinal muscle dysfunction in low back pain. Rheumatology in Europe 1999;28 (1) 12-4.
• Donahue D, Whetsell W ,Pathological considerations of the herniated nucleus pulposus. In Camins and P . Oleary Lumbar Spine. New York : Raven Press , 1987;427-437.
• Alaranta H, Luoto S, Heliovaara M, Hurri H. Static back endurance and the risk of low back pain. Clin Biomech 1995;10:323-4.
• Goel V, Kong W, Han JS, Weinstein JN, Gilbertson LG. A combined finite element and optimisation investigation of lumbar spine mechanics with and without muscles. Spine 1993; 18: 1531-1541