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European Spine Journal

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01-07-2019 | Scoliosis | Original Article

Abnormal change of paravertebral muscle in adult degenerative scoliosis and its association with bony structural parameters

Authors: Dongxiao Xie, Jinniu Zhang, Wenyuan Ding, Sidong Yang, Dalong Yang, Lei Ma, Jingtao Zhang

Published in: European Spine Journal | Issue 7/2019

Abstract

Purpose

While many studies have explored the association between paravertebral muscle (PVM) change and low back pain/lumbar spinal stenosis, little is known about PVM change in adult degenerative scoliosis (ADS). The present study explored the PVM change in ADS and investigated its association with bony structural parameters.

Methods

We evaluated 78 patients in ADS without radiculopathy (ADS group) and 65 healthy persons without degenerative lumbar diseases (control group). Percentage of fat infiltration area (%FIA) of multifidus muscle at L1 to S1 disk level was measured by MRI, using ImageJ software. Lumbar scoliosis Cobb’s angle, lumbar lordotic angle, lateral vertebral translation, and apical vertebral rotation were recorded in ADS group, and relationship between PVM change and these factors was analyzed.

Results

In the control group, the mean %FIA of multifidus muscle was not significantly different between the bilateral sides at all levels (P > 0.05). In the ADS group, the mean %FIA was significantly higher on the concave side than the convex side at all levels (P < 0.05). Asymmetric degree of multifidus muscle change was 8.55% ± 4.91%, which was positively correlated with lumbar scoliosis Cobb’s angle, lateral vertebral translation, and apical vertebral rotation (0 < r < 1, P < 0.05), but negatively weak-correlated with lumbar lordotic angle (− 1 < r < 0, P < 0.05).

Conclusions

Asymmetric PVM change in ADS is more often seen on the concave side, which is positive to evaluate the progression of scoliosis. Its asymmetric degree increases with progression of lumbar scoliosis Cobb’s angle and decreased lumbar lordotic angle. Apical vertebral rotation and lateral vertebral translation can aggravate the asymmetric degree.

Graphical abstract

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Aebi M (2005) The adult scoliosis. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. Eur Spine J 14(10):925–948. https://doi.org/10.1007/s00586-005-1053-9 CrossRef

Fu KM, Rhagavan P, Shaffrey CI, Chernavvsky DR, Smith JS (2011) Prevalence, severity, and impact of foraminal and canal stenosis among adults with degenerative scoliosis. Neurosurgery 69(6):1181–1187. https://doi.org/10.1227/NEU.0b013e31822a9aeb CrossRefPubMed

Bess S, Boachie-Adjei O, Burton D, Cunningham M, Shaffrey C, Shelokov A, Hostin R, Schwab F, Wood K, Akbarnia B (2009) Pain and disability determine treatment modality for older patients with adult scoliosis, while deformity guides treatment for younger patients. Spine 34(20):2186–2190. https://doi.org/10.1097/BRS.0b013e3181b05146 CrossRefPubMed

Jimbo S, Kobayashi T, Aono K, Atsuta Y, Matsuno T (2012) Epidemiology of degenerative lumbar scoliosis: a community-based cohort study. Spine 37(20):1763–1770. https://doi.org/10.1097/BRS.0b013e3182575eaa CrossRefPubMed

Silva FE, Lenke LG (2010) Adult degenerative scoliosis: evaluation and management. Neurosurg Focus 28(3):E1. https://doi.org/10.3171/2010.1.focus09271 CrossRefPubMed

Kang CH, Shin MJ, Kim SM, Lee SH, Lee CS (2007) MRI of paraspinal muscles in lumbar degenerative kyphosis patients and control patients with chronic low back pain. Clin Radiol 62(5):479–486. https://doi.org/10.1016/j.crad.2006.12.002 CrossRefPubMed

Hyun SJ, Bae CW, Lee SH, Rhim SC (2016) Fatty degeneration of the paraspinal muscle in patients with degenerative lumbar kyphosis: a new evaluation method of quantitative digital analysis using MRI and CT scan. Clin Spine Surg 29(10):441–447. https://doi.org/10.1097/BSD.0b013e3182aa28b0 CrossRefPubMed

Jiang J, Meng Y, Jin X, Zhang C, Zhao J, Wang C, Gao R, Zhou X (2017) Volumetric and fatty infiltration imbalance of deep paravertebral muscles in adolescent idiopathic scoliosis. Med Sci Monitor Int Med J Exp Clin Res 23:2089–2095CrossRef

Lee JC, Cha JG, Kim Y, Kim YI, Shin BJ (2008) Quantitative analysis of back muscle degeneration in the patients with the degenerative lumbar flat back using a digital image analysis: comparison with the normal controls. Spine 33(3):318–325. https://doi.org/10.1097/BRS.0b013e318162458f CrossRefPubMed

10.

Wu HL, Ding WY, Shen Y, Zhang YZ, Guo JK, Sun YP, Cao LZ (2012) Prevalence of vertebral endplate modic changes in degenerative lumbar scoliosis and its associated factors analysis. Spine 37(23):1958–1964. https://doi.org/10.1097/BRS.0b013e31825bfb85 CrossRefPubMed

11.

Kohno S, Ikeuchi M, Taniguchi S, Takemasa R, Yamamoto H, Tani T (2011) Factors predicting progression in early degenerative lumbar scoliosis. J Orthop Surg (Hong Kong) 19(2):141–144. https://doi.org/10.1177/230949901101900202 CrossRef

12.

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 Off Pub Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 15(6):764–773. https://doi.org/10.1007/s00586-005-0909-3 CrossRef

13.

Shafaq N, Suzuki A, Matsumura A, Terai H, Toyoda H, Yasuda H, Ibrahim M, Nakamura H (2012) Asymmetric degeneration of paravertebral muscles in patients with degenerative lumbar scoliosis. Spine 37(16):1398–1406. https://doi.org/10.1097/BRS.0b013e31824c767e CrossRefPubMed

14.

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(22):E515–E519CrossRefPubMed

15.

McGill SM, Grenier S, Kavcic N, Cholewicki J (2003) Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol Off J Int Soc Electrophysiol Kinesiol 13(4):353–359CrossRef

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(17):1888–1899. https://doi.org/10.1097/01.brs.0000229232.66090.58 CrossRefPubMed

17.

Guo X, Zhang X, Ding W, Yang D, Ma L, Xie D, Wang H, Wang H, Lu K, Yang S (2014) Imaging study of paravertebral muscle degeneration in degenerative lumbar instability. Zhonghua wai ke za zhi [Chin J Surg] 52(8):571–575

18.

Kalichman L, Carmeli E, Been E (2017) The Association between imaging parameters of the paraspinal muscles. Spinal Degener Low Back Pain 2017:2562957. https://doi.org/10.1155/2017/2562957 CrossRef

19.

Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, Bourgois J, Dankaerts W, De Cuyper HJ (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(3):186–191CrossRefPubMedPubMedCentral

20.

Kliziene I, Sipaviciene S, Klizas S, Imbrasiene D (2015) Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain. J Back Musculoskel Rehabil 28(4):841–847. https://doi.org/10.3233/bmr-150596 CrossRef

21.

Deckers K, De Smedt K, Mitchell B, Vivian D, Russo M, Georgius P, Green M, Vieceli J, Eldabe S, Gulve A, van Buyten JP, Smet I, Mehta V, Ramaswamy S, Baranidharan G, Sullivan R, Gassin R, Rathmell J, Gilligan C (2017) New therapy for refractory chronic mechanical low back pain-restorative neurostimulation to activate the lumbar multifidus: one year results of a prospective multicenter clinical trial. Neuromodul J Int Neuromod Soc. https://doi.org/10.1111/ner.12741 CrossRef

22.

Russo M, Deckers K, Eldabe S, Kiesel K, Gilligan C, Vieceli J, Crosby P (2017) Muscle control and non-specific chronic low back pain. Neuromod J Int Neuromod Soc. https://doi.org/10.1111/ner.12738 CrossRef

23.

Tunnell J (2009) Needle EMG response of lumbar multifidus to manipulation in the presence of clinical instability. J Manual Manip Ther 17(1):E19–E24. https://doi.org/10.1179/jmt.2009.17.1.19E CrossRef

24.

Hu ZJ, He J, Zhao FD, Fang XQ, Zhou LN, Fan SW (2011) An assessment of the intra- and inter-reliability of the lumbar paraspinal muscle parameters using CT scan and magnetic resonance imaging. Spine 36(13):E868–E874. https://doi.org/10.1097/BRS.0b013e3181ef6b51 CrossRefPubMed

25.

Murakami N, Obata K, Abe Y, Oto Y, Kido Y, Itabashi H, Tsuchiya T, Tanaka Y, Yoshino A, Nagai T (2012) Scoliosis in Prader–Willi syndrome: effect of growth hormone therapy and value of paravertebral muscle volume by CT in predicting scoliosis progression. Am J Med Gen Part A 158(7):1628–1632. https://doi.org/10.1002/ajmg.a.35429 CrossRef

26.

Kiesel KB, Butler RJ, Duckworth A, Halaby T, Lannan K, Phifer C, DeLeal C, Underwood FB (2012) Experimentally induced pain alters the EMG activity of the lumbar multifidus in asymptomatic subjects. Manual Therapy 17(3):236–240. https://doi.org/10.1016/j.math.2012.01.008 CrossRefPubMed

27.

Kalichman L, Hodges P, Li L, Guermazi A, Hunter DJ (2010) Changes in paraspinal muscles and their association with low back pain and spinal degeneration: cT study. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 19(7):1136–1144. https://doi.org/10.1007/s00586-009-1257-5 CrossRef

28.

Chon J, Kim HS (2017) Asymmetric atrophy of paraspinal muscles in patients with chronic unilateral lumbar radiculopathy. Ann Rehab Med 41(5):801–807. https://doi.org/10.5535/arm.2017.41.5.801 CrossRef

29.

Fortin M, Videman T, Gibbons LE, Battie MC (2014) Paraspinal muscle morphology and composition: a 15-yr longitudinal magnetic resonance imaging study. Med Sci Sports Exerc 46(5):893–901. https://doi.org/10.1249/mss.0000000000000179 CrossRefPubMed

30.

Bulcke JA, Termote JL, Palmers Y, Crolla D (1979) Computed tomography of the human skeletal muscular system. Neuroradiology 17(3):127–136PubMed

31.

Kalichman L, Klindukhov A, Li L, Linov L (2016) Indices of paraspinal muscles degeneration: reliability and association with facet joint osteoarthritis: feasibility study. Clin Spine Surg 29(9):465–470. https://doi.org/10.1097/BSD.0b013e31828be943 CrossRefPubMed

32.

Stokes M, Rankin G, Newham DJ (2005) Ultrasound imaging of lumbar multifidus muscle: normal reference ranges for measurements and practical guidance on the technique. Manual Therapy 10(2):116–126. https://doi.org/10.1016/j.math.2004.08.013 CrossRefPubMed

33.

Hyun JK, Lee JY, Lee SJ, Jeon JY (2007) Asymmetric atrophy of multifidus muscle in patients with unilateral lumbosacral radiculopathy. Spine 32(21):E598–E602. https://doi.org/10.1097/BRS.0b013e318155837b CrossRefPubMed

34.

Battie MC, Niemelainen R, Gibbons LE, Dhillon S (2012) Is level- and side-specific multifidus asymmetry a marker for lumbar disc pathology? Spine J Off J North Am Spine Soc 12(10):932–939. https://doi.org/10.1016/j.spinee.2012.08.020 CrossRef

35.

Goubert D, Oosterwijck JV, Meeus M, Danneels L (2016) Structural changes of lumbar muscles in non-specific low back pain: a systematic review. Pain Physician 19(7):E985–E999PubMed

36.

Butterworth TR Jr, James C (1969) Electromyographic studies in idiopathic scoliosis. South Med J 62(8):1008–1010CrossRefPubMed

37.

Fidler MW, Jowett RL (1976) Muscle imbalance in the aetiology of scoliosis. J Bone Joint Surg Br 58(2):200–201CrossRefPubMed

38.

Zoabli G, Mathieu PA, Aubin CE (2007) Back muscles biometry in adolescent idiopathic scoliosis. Spine J Off J North Am Spine Soc 7(3):338–344. https://doi.org/10.1016/j.spinee.2006.04.001 CrossRef

39.

Chan YL, Cheng JC, Guo X, King AD, Griffith JF, Metreweli C (1999) MRI evaluation of multifidus muscles in adolescent idiopathic scoliosis. Pediatr Radiol 29(5):360–363. https://doi.org/10.1007/s002470050607 CrossRefPubMed

40.

Reuber M, Schultz A, McNeill T, Spencer D (1983) Trunk muscle myoelectric activities in idiopathic scoliosis. Spine 8(5):447–456CrossRefPubMed

41.

Sapkas G, Efstathiou P, Badekas AT, Antoniadis A, Kyratzoulis J, Meleteas E (1996) Radiological parameters associated with the evolution of degenerative scoliosis. Bull Hosp Joint Dis NY 55(1):40–45

42.

Easwar TR, Hong JY, Yang JH, Suh SW, Modi HN (2011) Does lateral vertebral translation correspond to Cobb angle and relate in the same way to axial vertebral rotation and rib hump index? A radiographic analysis on idiopathic scoliosis. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 20(7):1095–1105. https://doi.org/10.1007/s00586-011-1702-0 CrossRef

43.

Kotwicki T, Napiontek M, Nowakowski A (2006) Transverse plane of apical vertebra of structural thoracic curve: vertebra displacement versus vertebral deformation. Stud Health Technol Inform 123:164–168PubMed

44.

Kotwicki T, Napiontek M (2008) Intravertebral deformation in idiopathic scoliosis: a transverse plane computer tomographic study. J Pediatr Orthop 28(2):225–229. https://doi.org/10.1097/BPO.0b013e3181647c4a CrossRefPubMed

45.

Asher MA, Cook LT (1995) The transverse plane evolution of the most common adolescent idiopathic scoliosis deformities. A cross-sectional study of 181 patients. Spine 20(12):1386–1391CrossRefPubMed

46.

Cheung J, Halbertsma JP, Veldhuizen AG, Sluiter WJ, Maurits NM, Cool JC, van Horn JR (2005) A preliminary study on electromyographic analysis of the paraspinal musculature in idiopathic scoliosis. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 14(2):130–137. https://doi.org/10.1007/s00586-004-0780-7 CrossRef

47.

Zetterberg C, Bjork R, Ortengren R, Andersson GB (1984) Electromyography of the paravertebral muscles in idiopathic scoliosis. Measurements of amplitude and spectral changes under load. Acta orthopaedica Scandinavica 55(3):304–309CrossRefPubMed

48.

Zapata KA, Wang-Price SS, Sucato DJ, Dempsey-Robertson M (2015) Ultrasonographic measurements of paraspinal muscle thickness in adolescent idiopathic scoliosis: a comparison and reliability study. Pediatr Phys Ther Off Publ Sect Pediatr Am Phys Therapy Assoc 27(2):119–125. https://doi.org/10.1097/pep.0000000000000131 CrossRef

49.

Murata Y, Takahashi K, Hanaoka E, Utsumi T, Yamagata M, Moriya H (2002) Changes in scoliotic curvature and lordotic angle during the early phase of degenerative lumbar scoliosis. Spine 27(20):2268–2273. https://doi.org/10.1097/01.brs.0000029261.05130.1a CrossRefPubMed

50.

Chun SW, Lim CY, Kim K, Hwang J, Chung SG (2017) The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. Spine J Off J North Am Spine Soc 17(8):1180–1191. https://doi.org/10.1016/j.spinee.2017.04.034 CrossRef

Title: Abnormal change of paravertebral muscle in adult degenerative scoliosis and its association with bony structural parameters
Authors: Dongxiao Xie
Jinniu Zhang
Wenyuan Ding
Sidong Yang
Dalong Yang
Lei Ma
Jingtao Zhang
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Scoliosis
Adolescent Idiopathic Scoliosis
Published in: European Spine Journal / Issue 7/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-05958-7

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Springer Medicine

Abnormal change of paravertebral muscle in adult degenerative scoliosis and its association with bony structural parameters

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

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