Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Correlation between intervertebral disc degeneration, paraspinal muscle atrophy, and lumbar facet joints degeneration in patients with lumbar disc herniation

Authors: Dong Sun, Peng Liu, Jie Cheng, Zikun Ma, Jingpei Liu, Tingzheng Qin

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Login to get access

Abstract

Background

To assess the correlation between lumbar disc degeneration (LDD), multifidus muscle atrophy (LMA), and facet joints degeneration in patients with L4-L5 lumbar disc herniation (LDH).

Methods

Sixty patients with L4-L5 LDH diagnosed by a 1.5 T MRI scanner were enrolled in the study group and another 60 patients with non-specific back pain were enrolled in the control group. LDD, LMA, and facet joints degeneration were examined and analyzed independently by two independent orthopedic surgeons using T2-weighted images. Wilcoxon test was used for analyzing the difference of LDD and facet joints degeneration between L3-L4 and L5-S1 and difference of LMA between the herniated and control groups. Correlation analysis of the three degeneration grades at the same level was determined by Spearman rank correlation test.

Results

In the herniated group, most LMA at L3-L4 level was grade 1 (42, 70.0%); grade 2 (33, 55.0%) at L4-L5 level; and grade 3 (27, 45.0%) at L5-S1 level. LMA and LDD grading were significantly different between L3-L4 and L5-S1 levels (P < 0.05). In the herniation group, the Spearman value for LDD and LMA grading were 0.352 (P < 0.01) at L3-L4 and 0.036 (P > 0.05) at the L5-S1 level. The differences in LMA between the herniated and control groups at the three levels were significant (P < 0.05).

Conclusions

Disc degeneration and multifidus muscles atrophy were positively correlated at the L3-L4 disc level. A lumbar extension muscle strengthening program could be helpful in preventing muscle atrophy and lumbar spinal degeneration.
Literature
1.
Porter RW. Management of back pain. London: Churchill Livingstone; 1986. p. 89–103.
2.
3.
Macintosh JE, Valencia F, Bogduk N, Munro RR. The morphology of the human lumbar multifidus. Clin Biomech (Bristol, Avon). 1986;1(4):196–204.CrossRef
4.
Macintosh JE, Bogduk N. The biomechanics of the lumbar multifidus. Clin Biomech (Bristol, Avon). 1986;1(4):205–13.CrossRef
5.
Zhao WP, Kawaguchi Y, Matsui H, Kanamori M, Kimura T. Histochemistry and morphology of the multifidus muscle in lumbar disc herniation: comparative study between diseased and normal sides. Spine (Phila Pa 1976). 2000;25(17):2191–9.CrossRef
6.
Yoshihara K, Shirai Y, Nakayama Y, Uesaka S. Histochemical changes in the multifidus muscle in patients with lumbar intervertebral disc herniation. Spine (Phila Pa 1976). 2001;26(6):622–6.CrossRef
7.
Freeman MD, Woodham MA, Woodham AW. The role of the lumbar multifidus in chronic low back pain: a review. PM R. 2010;2(2):142–6. quiz 141 p following 167.CrossRefPubMed
8.
Lee JC, Cha JG, Kim Y, Kim YI, Shin BJ. 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 (Phila Pa 1976). 2008;33(3):318–25.CrossRef
9.
Mengiardi B, Schmid MR, Boos N, Pfirrmann CW, Brunner F, Elfering A, Hodler J. Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. Radiology. 2006;240(3):786–92.CrossRefPubMed
10.
Tabaraee E, Ahn J, Bohl DD, Phillips FM, Singh K. Quantification of multifidus atrophy and fatty infiltration following a minimally invasive microdiscectomy. Int J Spine Surg. 2015;9:25.CrossRefPubMedPubMedCentral
11.
Takayama K, Kita T, Nakamura H, Kanematsu F, Yasunami T, Sakanaka H, Yamano Y. New predictive index for lumbar paraspinal muscle degeneration associated with aging. Spine (Phila Pa 1976). 2016;41(2):E84–90.CrossRef
12.
Battaglia PJ, Maeda Y, Welk A, Hough B, Kettner N. Reliability of the Goutallier classification in quantifying muscle fatty degeneration in the lumbar multifidus using magnetic resonance imaging. J Manipulative Physiol Ther. 2014;37(3):190–7.CrossRefPubMed
13.
Griffith JF, Wang YX, Antonio GE, Choi KC, Yu A, Ahuja AT, Leung PC. Modified Pfirrmann grading system for lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2007;32(24):E708–12.CrossRef
14.
Pathria M, Sartoris DJ, Resnick D. Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. Radiology. 1987;164(1):227–30.CrossRefPubMed
15.
Hodges P, Holm AK, Hansson T, Holm S. Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine (Phila Pa 1976). 2006;31(25):2926–33.CrossRef
16.
Bogduk N. Clinical anatomy of lumbar Spine and Sacrum. 3rd ed. Edinburgh: Churchill Livingston; 1997.
17.
Bakou S, Cherel Y, Gabinaud B, Guigand L, Wyers M. Type-specific changes in fibre size and satellite cell activation following muscle denervation in two strains of turkey (Meleagris gallopavo). J Anat. 1996;188(Pt 3):677–91.PubMedPubMedCentral
18.
Bishop DL, Milton RL. The effects of denervation location on fiber type mix in self-reinnervated mouse soleus muscles. Exp Neurol. 1997;147(1):151–8.CrossRefPubMed
19.
Okada Y. Histochemical study on the atrophy of the quadriceps femoris muscle caused by knee joint injuries of rats. Hiroshima J Med Sci. 1989;38(1):13–21.PubMed
20.
Herbison GJ, Jaweed MM, Ditunno JF. Muscle atrophy in rats following denervation, casting, inflammation, and tenotomy. Arch Phys Med Rehabil. 1979;60(9):401–4.PubMed
21.
Weber BR, Grob D, Dvorak J, Muntener M. Posterior surgical approach to the lumbar spine and its effect on the multifidus muscle. Spine (Phila Pa 1976). 1997;22(15):1765–72.CrossRef
22.
Kader DF, Wardlaw D, Smith FW. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol. 2000;55(2):145–9.CrossRefPubMed
23.
Richardson CA, Jull GA. Muscle control-pain control. What exercises would you prescribe? Man Ther. 1995;1(1):2–10.CrossRefPubMed
24.
Oosterhuis T, Costa LO, Maher CG, de Vet HC, van Tulder MW, Ostelo RW. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev. 2014;3:Cd003007.
25.
McGregor AH, Probyn K, Cro S, Dore CJ, Burton AK, Balague F, Pincus T, Fairbank J. Rehabilitation following surgery for lumbar spinal stenosis. Cochrane Database Syst Rev. 2013;12:Cd009644.
26.
Min SH, Kim MH, Seo JB, Lee JY, Lee DH. The quantitative analysis of back muscle degeneration after posterior lumbar fusion: comparison of minimally invasive and conventional open surgery. Asian Spine J. 2009;3(2):89–95.CrossRefPubMedPubMedCentral
27.
Bresnahan LE, Smith JS, Ogden AT, Quinn S, Cybulski GR, Simonian N, Natarajan RN, Fessler RD, Fessler RG. Assessment of paraspinal muscle cross-sectional area following lumbar decompression: minimally invasive versus open approaches. J Spinal Disord Tech. 2013;1536–0652.
28.
Pourtaheri S, Issa K, Lord E, Ajiboye R, Drysch A, Hwang K, Faloon M, Sinha K, Emami A. Paraspinal muscle atrophy after lumbar spine surgery. Orthopedics. 2016;39(2):e209–e214.
29.
Putzier M, Hartwig T, Hoff EK, Streitparth F, Strube P. Minimally invasive TLIF leads to increased muscle sparing of the multifidus muscle but not the longissimus muscle compared with conventional PLIF – a prospective randomized clinical trial. Spine J. 2016;16:811–9.
30.
Choi G, Raiturker PP, Kim MJ, Chung DJ, Chae YS, Lee SH. The effect of early isolated lumbar extension exercise program for patients with herniated disc undergoing lumbar discectomy. Neurosurgery. 2005;57(4):764–72. discussion 764-772.CrossRefPubMed
Metadata
Title
Correlation between intervertebral disc degeneration, paraspinal muscle atrophy, and lumbar facet joints degeneration in patients with lumbar disc herniation
Authors
Dong Sun
Peng Liu
Jie Cheng
Zikun Ma
Jingpei Liu
Tingzheng Qin
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1522-4

Other articles of this Issue 1/2017

BMC Musculoskeletal Disorders 1/2017 Go to the issue

Research article

Comparison of improved range of motion between cam-type femoroacetabular impingement and borderline developmental dysplasia of the hip -evaluation by virtual osteochondroplasty using computer simulation-

Research article

The efficacy and safety of tranexamic acid in revision total knee arthroplasty: a meta-analysis

Research article

Agonist muscle adaptation accompanied by antagonist muscle atrophy in the hindlimb of mice following stretch-shortening contraction training

Research article

Ten-year survival rate after rotational acetabular osteotomy in adulthood hip dysplasia

Research article

Strontium ranelate causes osteophytes overgrowth in a model of early phase osteoarthritis

Research article

Consultation patterns of children and adolescents with knee pain in UK general practice: analysis of medical records