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01-09-2013 | Original Article

MRI features of the psoas major muscle in patients with low back pain

Authors: Juraj Arbanas, Ivan Pavlovic, Verner Marijancic, Hrvoje Vlahovic, Gordana Starcevic-Klasan, Stanislav Peharec, Snjezana Bajek, Damir Miletic, Daniela Malnar

Published in: European Spine Journal | Issue 9/2013

Abstract

Purpose

The purpose was to investigate the changes of the psoas major muscles (PM) cross-sectional area (CSA) and fat infiltration in the PM and to investigate the association between the morphology of the PM and expression of the degenerative changes of lumbar spine in patients with low back pain (LBP).

Methods

T2-weighted scans for measurements of the CSA and analysis of fat infiltration were performed on 42 patients and 49 controls using a 1.5 Tesla MR system. For a quantitative analysis of fat tissue infiltration a 4-grade visual scale was used.

Results

Patients had bigger CSA of the PM than controls at the levels of L3/L4 and L4/L5 intervertebral disc (P < 0.05). Patients with apparent degenerative changes of the lumbar spine had smaller CSA of the PM compared to the patients without apparent changes at the levels of L3/L4 and L4/L5 (P < 0.05). At the levels of L4/L5 and L5/S1 patients with present Modic changes in the lumbar vertebral bodies showed smaller CSA of the PM compared to the patients without Modic changes (P < 0.05). However, CSA of the PM in the patients with degenerative changes of lumbar spine and Modic changes was still bigger than the one of the controls. At all analyzed levels correlation between CSAs of the PM and fat infiltration of the lumbar paraspinal muscles was negative.

Conclusion

Results suggest increased activity of the PM in LBP patients but PM also remains active regardless of the presence of degenerative and Modic changes of the lumbar spine.

Urban JP, Roberts S (2003) Degeneration of the intervertebral disc. Arthr Res Ther 5:120–130CrossRef

Mengiardi B, Schmid MR, Boos N, Pfirrmann CW, Brunner F, Elfering A, Hodler J (2006) Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. Radiology 240:786–792PubMedCrossRef

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

Standring S (2005) Gray’s anatomy, 39th edn. The anatomical basis of clinical practice. Elsevier, Curchill Livingstone, Edinburgh, pp 1444–1446

Penning L (2002) Spine stabilization by psoas muscle during walking and running. Eur Spine J 11:89–90PubMedCrossRef

Penning L (2000) Psoas muscle and lumbar spine stability: a concept uniting existing controversies. Eur Spine J 9:577–585PubMedCrossRef

Bogduk N, Pearcy M, Hadfield G (1992) Anatomy and biomechanics of psoas major. Clin Biomech 7:109–119CrossRef

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

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:E515–E519PubMedCrossRef

10.

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

11.

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

12.

Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, De Cuyper HJ (2000) CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 9:266–272PubMedCrossRef

13.

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 13:349–356PubMedCrossRef

14.

Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf-Yde C (2007) Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? BMC Med 5:2PubMedCrossRef

15.

Videman T, Battié MC, Gill K, Manninen H, Gibbons LE, Fisher LD (1995) Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration. Spine 20:928–935PubMedCrossRef

16.

Hansen L, de Zee M, Rasmussen J, Andersen TB, Wong C, Simonsen EB (2006) Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling. Spine 31:1888–1899PubMedCrossRef

17.

Zhao F, Pollintine P, Hole BD, Dolan P, Adams MA (2005) Discogenic origins of spinal instability. Spine 30:2621–2630PubMedCrossRef

18.

Ranson CA, Burnett AF, Kerslake R, Batt ME, O’Sullivan PB (2006) An investigation into the use of MR imaging to determine the functional cross-sectional area of lumbar paraspinal muscles. Eur Spine J 15:764–773PubMedCrossRef

19.

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

20.

Modic MT, Ross JS (2007) Lumbar degenerative disk disease. Radiology 245:43–61PubMedCrossRef

21.

Rahme R, Moussa R (2008) The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR Am J Neuroradiol 29:838–842PubMedCrossRef

22.

Albert HB, Manniche C (2007) Modic changes following lumbar disc herniation. Eur Spine J 16:977–982PubMedCrossRef

23.

Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30:1173–1180PubMedCrossRef

24.

Crombez G, Vervaet L, Lysens R, Baeyens F, Eelen P (1998) Avoidance and confrontation of painful, back-straining movements in chronic back pain patients. Behav Modif 22:62–77PubMedCrossRef

25.

Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878PubMedCrossRef

Title: MRI features of the psoas major muscle in patients with low back pain
Authors: Juraj Arbanas
Ivan Pavlovic
Verner Marijancic
Hrvoje Vlahovic
Gordana Starcevic-Klasan
Stanislav Peharec
Snjezana Bajek
Damir Miletic
Daniela Malnar
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 9/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-013-2749-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

MRI features of the psoas major muscle in patients with low back pain

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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