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Magnetic resonance imaging of lumbar trunk parameters in chronic low backache patients and healthy population: a comparative study

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Abstract

Purpose

The aim of this study was to evaluate the lumbar trunk parameters by MRI and investigate their association with chronic low backache.

Methods

Fifty patients (26 males and 24 females) with mean age 33.54 ± 8.33 years with a history of low back pain (LBP) of minimum 3 consecutive months constituted the study group (Group A). To match with the study group, 15 normal healthy volunteers (9 males and 6 females) with no history of back pain were selected (Group B). Both the groups were subjected to magnetic resonance imaging of lumbosacral spine and lumbar trunk parameters were calculated.

Results

Trunk width, depth and skin angle were comparable at L3–L4, L4–L5 and L5–S1 disc levels; significant difference with regard to disc angle of L3–L4 (p = 0.005) and L4–L5 (p = 0.02) and cross-sectional area (CSA) of disc at L4–L5 level (p = 0.01) was observed between two groups. There was a tendency of smaller CSA of paraspinal and abdominal oblique muscles in Group A patients, but the measurements were not statistically different from Group B patients. Rectus abdominis muscles showed a unique pattern of larger CSA at L3–L4 and L4–L5 disc levels and smaller CSA at L5–S1 in LBP patients. Intervertebral disc degenerative changes on MRI were observed in 27 (54 %) patients in the Group A; and none of the Group B participants showed degenerative changes.

Conclusions

Tendency of smaller trunk musculature CSA may be a cause or a result of chronic LBP. A unique pattern of larger CSA at L3–L4 and L4–L5 disc levels and smaller CSA at L5-S1 of Rectus abdominis muscles is observed in LBP patients compared to healthy persons. Differences in disc angles and CSA of disc at L3–L4 and L4–L5 levels between the two groups signify that these may be the predisposing factors leading to LBP due to abnormal load/stress transmission and precipitating early degenerative changes in the disc.

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References

  1. Andersson GBJ (1999) Epidemiological features of chronic low-back pain. Lancet 354:581–585

    Article  CAS  PubMed  Google Scholar 

  2. Deyo RA, Weinstein JN (2001) Low back pain. N Engl J Med 344:363–370

    Article  CAS  PubMed  Google Scholar 

  3. Von Korff M, Deyo RA, Cherkin D et al (1993) Back pain in primary care: outcomes at 1 year. Spine 18:855–862

    Article  Google Scholar 

  4. Videman T, Battié MC, Gibbons LE et al (2003) Associations between back pain history and lumbar MRI findings. Spine 28:582–588

    PubMed  Google Scholar 

  5. Schwarzer AC, Aprill CN, Derby R et al (1994) The relative contributions of the disc and zygapophyseal joint in chronic low back pain. Spine 19:801–806

    Article  CAS  PubMed  Google Scholar 

  6. Wang Y, Videman T, Battié MC (2012) Lumbar vertebral endplate lesions: prevalence, classification, and association with age. Spine 37:1432–1439

    Article  PubMed  Google Scholar 

  7. Mengiardi B, Schmid MR, Boos N et al (2006) Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. Radiology 240:786–792

    Article  PubMed  Google Scholar 

  8. Danneels LA, Vanderstraeten GG, Cambier DC et al (2000) CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 9:266–272

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Fortin M, Macedo L (2013) Multifidus and paraspinal muscle group cross-sectional areas of patients with low back pain and control patients: a systematic review with a focus on blinding. Phys Ther 93:873–888

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kamaz M, Kiresi D, Oguz H et al (2007) CT measurement of trunk muscle areas in patients with chronic low pain. Diagn Interv Radiol 13:144–148

    PubMed  Google Scholar 

  11. Kay AG (2001) An extensive literature review of the lumbar multifidus: biomechanics. J Man Manip Ther 9:17–39

    Article  Google Scholar 

  12. D’hooge R, Cagnie B, Crombez G et al (2013) Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI. Clin J Pain (United States) 29(3):187–194

    Article  Google Scholar 

  13. Hides J, Gilmore C, Stanton W et al (2008) Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther 13:43–49

    Article  PubMed  Google Scholar 

  14. Kim HW, Lee SH, Lee DY (2011) Changes in the cross sectional area of multifidus and psoas in unilateral sciatica caused by lumbar disc herniation. J Korean Neurosurg Soc 50:201–204

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kjaer PI, Bendix T, Sorensen JS et al (2007) MRI-defined fat infiltrations in the multifidus muscles associated with low back pain. BMC Med 5:2–10

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kader DF, Wardlaw D, Smith FW (2000) Correlation between the MRI changes in the lumbar muldifidus muscles and leg pain. Clin Radiol 55:145–149

    Article  CAS  PubMed  Google Scholar 

  17. Niemeläinen R, Briand M, Battié MC (2011) Substantial asymmetry in paraspinal muscle cross-sectional area in healthy adults questions its value as a marker of LBP and pathology. Spine 36:2152–2157

    Article  PubMed  Google Scholar 

  18. Ranson C, Burnett A, O’Sullivan P et al (2008) The lumbar paraspinal muscle morphometry of fast bowlers in cricket. Clin J Sport Med 18:31–37

    Article  PubMed  Google Scholar 

  19. Hides J, Fan T, Stanton W et al (2010) Psoas and quadratus lumborum muscle asymmetry among elite Australian football league players. Br J Sports Med 44:563–567

    Article  CAS  PubMed  Google Scholar 

  20. Danneels LA, Vanderstraeten GG, Cambier DC et al (2001) Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. Br J Sports Med 35:186–191

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ploumis A, Michailidis N, Christodoulou P et al (2011) Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease. Br J Radiol 84:709–713

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Hyun JK, Lee JY, Lee SJ et al (2007) Asymmetric atrophy of multifidus muscle in patients with unilateral lumbosacral radiculopathy. Spine 32:598–602

    Article  Google Scholar 

  23. Lee Hak II, Song I, Lee HS, Kang JY, Kim M, Ryu JS et al (2011) Association between cross-sectional areas of lumbar muscles on magnetic resonance imaging and chronicity of low back pain. Ann Rehabil Med 35:852–859

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tracy MF, Gibson MJ, Szypryt EP et al (1989) The geometry of the muscles of the lumbar spine determined by magnetic resonance imaging. Spine 14:186–193

    Article  CAS  PubMed  Google Scholar 

  25. Tarantino U, Fanucci E, Iundusi R et al (2013) Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes. J Orthop Traumatol 14:15–22

    Article  PubMed  Google Scholar 

  26. Bailly F, Maigne JY, Genevay S et al (2014) Inflammatory pain pattern and pain with lumbar extension associated with Modic 1 changes on MRI: a prospective case-control study of 120 patients. Eur Spine J 23:493–497

    Article  CAS  PubMed  Google Scholar 

  27. Barker KL, Shamley DR, Jackson D (2004) Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine 29:515–519

    Article  Google Scholar 

  28. Dangaria TR, Naesh O (1998) Changes in cross-sectional area of psoas major muscle in unilateral sciatica caused by disc herniation. Spine 23:928–931

    Article  CAS  PubMed  Google Scholar 

  29. Parkkola R, Rytokoski U, Kormano M (1993) Magnetic resonance imaging of the of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects. Spine 18:830–836

    Article  CAS  PubMed  Google Scholar 

  30. Ropponen A, Videman T, Battié MC (2008) The reliability of paraspinal muscles composition measurements using routine spine MRI and their association with back function. Man Ther 13:349–356

    Article  PubMed  Google Scholar 

  31. Stokes MJ, Cooper RG, Morris G et al (1992) Selective changes in multifidus dimensions in patients with chronic low back pain. Eur Spine J 1:38–42

    Article  CAS  PubMed  Google Scholar 

  32. Gibbons LE, Latikka P, Videman T et al (1997) Association of trunk muscle cross-sectional area and magnetic resonance image parameters with isokinetic and psychophysical lifting strength and static back muscle endurance in men. J Spinal Disord 10:398–403

    Article  CAS  PubMed  Google Scholar 

  33. Ghiasi MS, Arjmand N, Shirazi-Adl A et al (2016) Cross-sectional area of human trunk paraspinal muscles before and after posterior lumbar surgery using magnetic resonance imaging. Eur Spine J 25:774–782

    Article  PubMed  Google Scholar 

  34. Stokes M, Rankin G, Newham DJ (2005) Ultrasound imaging of lumbar multifidus muscle: normal reference ranges for measurements and practical guidance on the technique. Man Ther 10:116–126

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, Pt. B.D. Sharma PGIMS, 52/9-J, Medical Enclave, Rohtak, 124001, Haryana, India

    Roop Singh & Sushil Kumar Yadav

  2. Department of Physiology, Pt. B.D. Sharma PGIMS, Rohtak, 124001, Haryana, India

    Sushma Sood

  3. Department of Radiodiagnosis, Pt. B.D. Sharma PGIMS, Rohtak, 124001, Haryana, India

    Rohtas Kumar Yadav

  4. Department of Social and Preventive Medicine, Pt. B.D. Sharma PGIMS, Rohtak, 124001, Haryana, India

    Ravi Rohilla

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  1. Roop Singh
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  2. Sushil Kumar Yadav
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  3. Sushma Sood
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  4. Rohtas Kumar Yadav
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Correspondence to Roop Singh.

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Singh, R., Yadav, S.K., Sood, S. et al. Magnetic resonance imaging of lumbar trunk parameters in chronic low backache patients and healthy population: a comparative study. Eur Spine J 25, 2864–2872 (2016). https://doi.org/10.1007/s00586-016-4698-7

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  • DOI: https://doi.org/10.1007/s00586-016-4698-7

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