Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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Quantitative analysis of lumbar multifidus atrophy with low back pain patients using Magnetic Resonance Image

자기공명영상(MRI)을 통한 요통환자의 다열근 위축에 대한 정량적 분석

  • Yang, Dae-Jung (Department of Physical Therapy, Graduate School of Dong Shin University)
  • 양대중 (동신대학교 대학원 물리치료학과)
  • Received : 2010.10.01
  • Accepted : 2010.11.17
  • Published : 2010.11.30
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Abstract

Purpose : The purpose of this study was to compare chronic LBP patients and asymptomatic subjects on measures of multifidus size (cross-sectional area;CSA, thickness) and symmetry (proportional difference of relatively larger side to smaller side). Methods : Data were obtained from 12 asymptomatic subjects without a prior history of LBP (8 females, 4 males), and a retrospective audit was undertaken of records from 12 chronic low back pain patients (8 females, 4 males). CSA and Thickness of the lumbar multifidus muscles was measured from axial T1-weighted magnetic resonance images(MRI). Results : The results of the analysis showed that chronic LBP patients had significantly smaller multifidus CSA and thickness than asymptomatic subjects at L4-5 vertebral levels(p<.05). The asymmetry between sides was seen at L4- L5 vertebral level in patients with chronic low back pain presentations(p<.05). Conclusions : MRI provided a quantitative measure of change between asymptomatic subjects and chronic low back pain patients of multifidus muscle. MRI identified significant differences in cross-sectional area and thickness and helps to evaluate clinically and plan the treatment modalities of LBP.

Keywords

References

  1. 대한 임상 통증학회. 근골격계 통증의학 II. 서울, 한미의학. 2008:699.
  2. 배지혜, 나진경, 유지연 등. 요통 환자의 다열근위축에 대한 고찰. 대한재활의학회지. 2001;25(4):684-91.
  3. 이원제. 6주간의 Sling 운동과 Medx 운동이 만성요통환자의 요부근력 안정화에 미치는 영향. 한국체육학회지. 2005;44(5):485-92.
  4. 최희수, 권오륜, 이충휘, 전혜선 등. 요부 안정화 운동에 따른 몸통근육들의 근 활성도 비교. 한국전문물리치료학회지. 2005;12(1):1-10.
  5. Andersson GBJ. Epidemiological features of chronic back pain. Lancet. 1999;354(9178):581-5. https://doi.org/10.1016/S0140-6736(99)01312-4
  6. Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain-the relationship to pain and disability. Spine. 2004;29(22):E515-.9. https://doi.org/10.1097/01.brs.0000144405.11661.eb
  7. Bogduk N, Twomey LT. Clinical Anatomy of the Lumbar Spine and sacrum. 2nd edition. Melbourne PA: Churchill Livingstone.1991;86-9.
  8. Kang CH, Shin MJ, Kim SM et al. MRI of paraspinal muscle in lumbar degenerative kyphosis patients and control patients with chronic low back pain. Clinical Radiology. 2007;62(5):479-86. https://doi.org/10.1016/j.crad.2006.12.002
  9. Cooper RG, Forbes W, Jayson et al. Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain. JOR. 1992; 31(6):389-94.
  10. Deyo RA, Tsui-Wu YJ. Functional disability due to low back pain.a population based study indicating the importance of socioeconomic factors Arthritis Rheum 1987;30(11):1247-53. https://doi.org/10.1002/art.1780301107
  11. Donald A Neumann. Kinesiology of the musculoskeletal system. 서울:정담미디어. 2002:491.
  12. Grabiner MD, Koh TJ, Elghazawi A. Decoupling of bilateral paraspinal excitation in subjects with low back pain. Spine 1992;17(10):1219-23. https://doi.org/10.1097/00007632-199210000-00015
  13. Hides JA, Stokes MJ, Saide M, et al. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine. 1994;19(2):165-72.
  14. Hides JA, Richardson CA, Jull GA. Multifidus recovery is not automatic following resolution of acute, first-episode of low back pain. Spine. 1996; 21(23):2763-69. https://doi.org/10.1097/00007632-199612010-00011
  15. Kader DF, Wardlow D, Smith FW. Correlation between the MRI changes in the lumbar multifidus muscle and leg pain. Clinical Radiology. 2000;55(2):145-9. https://doi.org/10.1053/crad.1999.0340
  16. Kamaz M, Kıresi D, Oguz, H et al. CT measurement of trunk muscle areas in patients with chronic low back pain. Diagn Interv Radiol. 2007;13(3): 144-8.
  17. Lamminen AE. Magnetic resonance imaging of primary skeletal muscle disease; patterns of distribution and severity of involvement. Br JR adiol. 1990; 63(756):946-50.
  18. Mc Gill SM. The biomechanics of low back injury: implications on current practice in industry at the clinic. J Biomech 1997;30(5):465-75. https://doi.org/10.1016/S0021-9290(96)00172-8
  19. Nakamura T, Kurosawa H, Kawahara H, et al. Muscle fiber atrophy in the quadriceps in knee joint disorders. Histochemical studies on 112 case. Arch Orthop Trauma Surg. 1986;105(3): 163-9. https://doi.org/10.1007/BF00433935
  20. Parkkola R, Rytokoski U, Kormano M. Magnetic resonance imaging of the discs and trunk muscles in pationts with chronic low back pain and healthy control subjects. spine. 1993(7);18:830-6. https://doi.org/10.1097/00007632-199306000-00004
  21. Savage RA, Whitehouse GH. Roberts N. The relationship between the magnetic resonance imaging apperance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J. 1997;6(2):106-14. https://doi.org/10.1007/BF01358742
  22. Stokes M, Rankin G, Newham DJ. Magnetic resonance imaging of primary skeletal muscle disease; patterns of distribution and severity of involvement. Manual Therapy 2005;10: 116-26. https://doi.org/10.1016/j.math.2004.08.013