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Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Back Pain | Research

The morphological characteristics of paraspinal muscles in young patients with unilateral neurological symptoms of lumbar disc herniation

Authors: Xuan Zhao, Huiqiang Liang, Zijian Hua, Wenshuai Li, Jia Li, Linfeng Wang, Yong Shen

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

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Abstract

Objective

The objective of this study was to explore the morphological characteristics of paraspinal muscles in young patients with unilateral neurological symptoms of lumbar disc herniation.

Methods

This study retrospectively analyzed young patients aged 18–40 years who were hospitalized for lumbar disc herniation in our hospital from June 2017 to June 2020. Data on sex, age, body mass index (BMI), subcutaneous fat tissue thickness (SFTT) at the L1-L2 level, duration of symptoms, degree of lumbar disc herniation, visual analog scale (VAS) for the lower back, Mo-fi-disc score, relative cross-sectional area (RCAS) of the paravertebral muscles (psoas major [PM], multifidus [MF], and erector spinae [ES]), and degree of fat infiltration (DFF) of the paravertebral muscles were collected. The VAS was used to evaluate the intensity of low back pain. Patients with VAS-back >4 points were defined as the low back pain group, and patients with ≤4 points were defined as the control group. The demographic characteristics, as well as the bilateral and ipsilateral paravertebral muscles, of the two groups were compared and analyzed.

Result

A total of 129 patients were included in this study (52 patients in the LBP group and 77 patients in the control group). There were no significant differences in sex, BMI, or Pfirrmann grade of lumbar disc herniation between the two groups (P > 0.05). The age of the LBP group (33.58 ± 2.98 years) was greater than that of the control group (24.13 ± 2.15 years) (P = 0.002), and the SFTT at the L1-L2 level (13.5 ± 7.14 mm) was higher than that of the control group (7.75 ± 6.31 mm) (P < 0.05). Moreover, the duration of symptoms (9.15 ± 0.31 months) was longer than that of the control group (3.72 ± 0.48 months) (P < 0.05), and the Mo-fi-disc score (8.41 ± 3.16) was higher than that of the control group (5.53 ± 2.85) (P < 0.05). At L3/4 and L5/S1, there was no significant difference in the RCSA and DFF of the bilateral and ipsilateral paraspinal muscles between the LBP group and the control group. At L4/5, there was no significant difference in the RCSA and DFF of the paraspinal muscles on either side in the LBP group (P > 0.05). In the control group, the RCSA of the MF muscle on the diseased side was smaller than that on the normal side (P < 0.05), and the DFF of the MF muscle on the diseased side was larger than that on the normal side (P < 0.05). In addition, there was no significant difference in the ES and PM muscles on both sides (P > 0.05). At L4/5, the RCSA of the MF muscle on the normal side was significantly smaller in the LBP group than in the control group (P < 0.05), and the DFF of the MF muscle on the normal side was significantly larger in the LBP group than in the control group (P < 0.05). There was no significant difference in the ES and PM muscles on the same side between the two groups (P > 0.05).

Conclusion

In young patients with unilateral neurological symptoms of lumbar disc herniation, symmetrical atrophy of the bilateral MF muscle is more prone to causing low back pain. Older age, higher SFTT at the L1-L2 levels, longer symptom duration, higher Mo-fi-di score, and greater muscle atrophy on the normal side of the MF increased the incidence of low back pain in young patients with unilateral lumbar disc herniation.
Literature
7.
go back to reference Özcan-Ekşi EE, Ekşi MŞ, Akçal MA. Severe lumbar intervertebral disc degeneration is associated with Modic changes and fatty infiltration in the Paraspinal muscles at all lumbar levels, except for L1-L2: a Cross-sectional analysis of 50 symptomatic women and 50 age-matched symptomatic men. World Neurosurg 2019 ;122:e1069-e1077. doi: https://doi.org/10.1016/j.wneu.2018.10.229. Epub 2018 Nov 9. PMID: 30415054. Özcan-Ekşi EE, Ekşi MŞ, Akçal MA. Severe lumbar intervertebral disc degeneration is associated with Modic changes and fatty infiltration in the Paraspinal muscles at all lumbar levels, except for L1-L2: a Cross-sectional analysis of 50 symptomatic women and 50 age-matched symptomatic men. World Neurosurg 2019 ;122:e1069-e1077. doi: https://​doi.​org/​10.​1016/​j.​wneu.​2018.​10.​229. Epub 2018 Nov 9. PMID: 30415054.
16.
go back to reference Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545–2550. doi: https://doi.org/10.1016/j.pain.2014.09.014. Epub 2014 Sep 17. PMID: 25239073. Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545–2550. doi: https://​doi.​org/​10.​1016/​j.​pain.​2014.​09.​014. Epub 2014 Sep 17. PMID: 25239073.
20.
go back to reference Özcan-Ekşi EE, Kara M, Berikol G, Orhun Ö, Turgut VU, Ekşi MŞ. A new radiological index for the assessment of higher body fat status and lumbar spine degeneration. Skelet Radiol 2022;51(6):1261–1271. doi: https://doi.org/10.1007/s00256-021-03957-8. Epub 2021 Nov 18. PMID: 34792625. Özcan-Ekşi EE, Kara M, Berikol G, Orhun Ö, Turgut VU, Ekşi MŞ. A new radiological index for the assessment of higher body fat status and lumbar spine degeneration. Skelet Radiol 2022;51(6):1261–1271. doi: https://​doi.​org/​10.​1007/​s00256-021-03957-8. Epub 2021 Nov 18. PMID: 34792625.
25.
go back to reference Rageot E. Le syndrome des branches postérieures des nerfs rachidiens. Bases anatomiques, sémiologiques et thérapeutiques [Syndrome of the posterior branches of spinal nerves. Anatomic, symptomatologic and therapeutic basis]. J Chir (Paris). 1982 Aug-Sep;119(8–9):517–22. French. Rageot E. Le syndrome des branches postérieures des nerfs rachidiens. Bases anatomiques, sémiologiques et thérapeutiques [Syndrome of the posterior branches of spinal nerves. Anatomic, symptomatologic and therapeutic basis]. J Chir (Paris). 1982 Aug-Sep;119(8–9):517–22. French.
39.
go back to reference Willemink MJ, van Es HW, Helmhout PH, Diederik AL, Kelder JC, van Heesewijk JP. The effects of dynamic isolated lumbar extensor training on lumbar multifidus functional cross-sectional area and functional status of patients with chronic nonspecific low back pain. Spine (Phila Pa 1976). 2012;37(26):E1651–8. https://doi.org/10.1097/BRS.0b013e318274fb2f.CrossRef Willemink MJ, van Es HW, Helmhout PH, Diederik AL, Kelder JC, van Heesewijk JP. The effects of dynamic isolated lumbar extensor training on lumbar multifidus functional cross-sectional area and functional status of patients with chronic nonspecific low back pain. Spine (Phila Pa 1976). 2012;37(26):E1651–8. https://​doi.​org/​10.​1097/​BRS.​0b013e318274fb2f​.CrossRef
Metadata
Title
The morphological characteristics of paraspinal muscles in young patients with unilateral neurological symptoms of lumbar disc herniation
Authors
Xuan Zhao
Huiqiang Liang
Zijian Hua
Wenshuai Li
Jia Li
Linfeng Wang
Yong Shen
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05968-5

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