• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.18-25
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• 2018

Purpose: To investigate the various imaging factors associated with aggravation of lumbar disc herniation (LDH) and develop a scoring system for prediction of LDH aggravation. Materials and Methods: From 2015 to 2017, we retrospectively reviewed the magnetic resonance imaging (MRI) findings of 60 patients (30 patients with aggravated LDH and 30 patients without any altered LDH). Imaging factors for MRI evaluation included the level of LDH, disc degeneration, back muscle atrophy, facet joint degeneration, ligamentum flavum thickness and interspinous ligament degeneration. Flexion-extension difference was measured with simple radiography. The scoring system was analyzed using receiver operating characteristic (ROC) analysis. Results: The aggravated group manifested a higher grade of disc degeneration, back muscle atrophy and facet degeneration than the control group. The ligamentum flavum thickness in the aggravated group was thicker than in the group with unaltered LDH. The summation score was defined as the sum of the grade of disc degeneration, back muscle atrophy and facet joint degeneration. The area under the ROC curve showing the threshold value of the summation score for prediction of aggravation of LDH was 0.832 and the threshold value corresponded to 6.5. Conclusion: Disc degeneration, facet degeneration, back muscle atrophy and ligamentum flavum thickness are important factors in predicting aggravation of LDH and may facilitate the determination of treatment strategy in patients with LDH. The summation score is available as supplemental data.

• 한방재활의학과학회지
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• 제19권4호
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• 척추신경추나의학회지
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• 제3권2호
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• pp.61-68
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• 2008

Objectives : Lumbar multifidus muscle stabilize lumbar spine. Atrophy of multifidus muscle follows disfunction of low back pain patient's activity and increase the reoccurency of herniation of nucleus purposus surgery. Lumbar herniation of nucleus purposus if common cause of low back pain. We have evaluated the atrophy of multifidus of nucleus purposus. Methods : Five patients were diagnosed as Lumbar herniation of nucleus purposus through the CT imaging. CT imaging were visually analysed to know lumbar multifidus muscle atrophy. Results and Conclusions : Examination of multifidus muscle atrophy should be considered with assessing CT imaging of lumbar spine. It may help for further evaluation and planning the treatment of Lumbar herniation of nucleus purposus patient.

• The Journal of Korean Physical Therapy
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• 제30권5호
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• pp.173-180
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• 2018

Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

• Physical Therapy Rehabilitation Science
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• 제1권1호
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• pp.28-32
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• 2012

Objective: The purpose of this study is to compare chronic low back pain patients' pain provocation position so as to identify the relevance with lumbar stabilizing muscles atrophy and pain provocation position. Design: Cross-sectional study. Methods: Fifty five chronic low back pain patients were participated in this study. Subjects were eligible for study participation if they were 35-55 years old and had experienced low back pain for more than 3 months. Subjects were questioned about pain and pain provocation test were done. And then they were inspected their cross sectional area (CSA) of lumbar muscles (erector spinae, iliopsoas, and multifidus) by using computed tomography. Analyze the relevance through the result data with painful area, aspect of pain and pain provocation position. Results: CSA of erector spinae showed significant decrease on ipsilateral extension position (p<0.05). Iliopsoas muscle showed significant decrease on contralateral position (p<0.05). Multifidus showed significant decrease on the position of contralateral extension and contralateral flexion (p<0.05). Conclusions: Based on the results of our study, it may be possible to evaluate muscle atrophy by assessing causing position.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.130-134
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• 2018

A 36-year-old male patient developed diffuse low back pain. His past medical history was unremarkable and had no family history of neuromuscular disease. He had no bladder and bowel problems. Creatine kinase was 172 U/L (normal < 170). Other fluid and blood chemistry tests were normal. Manual muscle test grades of extremities and sensory examination were normal. Muscle stretch reflexes were normal. Fasciculations and myotonia were not detected. Straight leg raising test was negative. There was no spinal root compression, spinal stenosis, or signal intensity change of spinal cord on magnetic resonance imaging (MRI). Fatty change and atrophy of the cervical, thoracic and lumbar paraspinal muscles were noted on MRI. Nerve conduction studies were normal. Electromyography showed 1+ positive sharp waves in the lumbar paraspinal muscles. Electromyography of upper and lower extremity muscles revealed no abnormal spontaneous activity. We report a rare case of severe paraspinal muscle atrophy with fatty degeneration in a Young Adult.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.39-47
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• 2010

Purpose: The purpose of this study was to characterize changes in back muscles in patients with chronic back pain. Accordingly, we studied 154 patients with chronic low back pain with regard to area, aspect and triggering position of the pain. We also determined muscle atrophy in painful areas. Methods: Subjects were questioned about pain and a pain provoking test was done. On Magnetic Resonance Imaging (MRI), we measured cross sections of the multifidus, erector spinae, iliopsoas and quadratus lumborum muscles at each spinal level. Results: Muscles in painful regions (multifidus and erector spinae muscles) decreased in area significantly more than nonpainful regions, and showed a significant difference (p<0.05) at levels L3, L4, and L5. Painful regions of the iliopsoas and quadratus lumborum did not change significantly more than non-painful regionsexcept at L5 (p<0.05). The group that had unilateral low back pain showed a significant decrease in cross section compared to the group that had central or bilateral pain (p<0.05). Conclusion: Chronic low back pain causes variable decreases in cross-sectional areas of some but not all back muscles, and at some but not all spinal levels.

• PNF and Movement
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• 제12권1호
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• pp.39-43
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• 2014

Purpose: This study was to examine lateral abdominal muscle activation during maximum expiration exercise between healthy and chronic low back pain(CLBP) patients. Methods: The subjects were 16 CLBP patients and 16 healthy people between the ages of 22 and 53. The thickness of the abdominal muscles was measured using ultrasonography(LOGIQ Book XP, GE, USA). We instructed the subjects how to perform the exercises and measured changes in thickness of the transversus abdominis(TrA) and internal oblique(IO) muscles during the maximum expiration. The main outcome variables were the ratios of the TrA and IO thickness during the exercise versus in the relaxed position(TrA and IO activation ratios). Results: There were significant differences between CLBP patients and healthy subjects for TrA in the relaxed position. However there was no difference in the ratio of change in the muscle activity(TrA, IO). Conclusion: These findings, CLBP patients exhibited atrophy of the TrA muscle, but voluntary TrA muscle activation was similar to that of the normal subjects. Therefore, this exercise could be used during core strengthening in CLBP patients.

• 한국콘텐츠학회논문지
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• 제11권6호
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• pp.270-278
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• 2011

이 연구는 20대와 40대의 급성과 만성 요통환자를 대상으로 척추 주위근육의 단면도를 비교하는 것이다. 20대(남자-9, 여자-10)와 40대(남자-8, 여자9)의 대상자들은 MRI로 요추(4번 하부 종단판) 단면도의 척추주위근육(장요근, 다열근, 척추기립근)들의 크기를 PACS(free-handling technique of the picture archiving and communication system(PACS)을 이용하여 측정하였다. 연구 결과 20대 급성과 만성 요통 환자들의 척추 주위근들의 차이는 통계학적으로 유의성이 없게 나타났으나, 40대 급성과 만성 요통환자들의 척추 주위근들의 차이는 만성 요통환자들이 근 위축이 통계학적으로 유의성 있게 나타났다. 또한 20대와 40대의 만성요통환자 척추 주위근들의 차이도 40대 만성요통 환자들에게 유의성 있게 나타났다. 연구에서 20대 만성환자들의 근 위축은 나타나지 않았으나 40대 만성환자들은 다양한 이유로 근 위축이 나타났다. 따라서 40대의 만성 요통환자들은 조기의 다양한 요부 근력 운동 및 기능적 활동 등으로 허리 주위근육의 위축을 감소시키는 것이 필요하다.

• Journal of Acupuncture Research
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• 제19권2호
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• pp.128-136
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• 2002

Objective : The purpose of this study was to evaluate water distribution differences of the right and left low limb in patients who had low back pain with sciatica or not. Methods : Water distribution differences of the right and left low limb by body composition(INBODY 2.0, Biospace, seoul, korea) were analysed in the views of groups(low back pain with and without sciatica) and duration of disease. Results : 1. In the case of low back pain patient, there was no significance in variance of water distribution of the right and left lower limbs regardless of suffering period, but significance difference in patients that have suffered low back pain with one side sciatica showed according to suffering period. 2. Within 2 weeks, there was no significant deflection between low back pain with and without sciatica in water distribution of the right and left lower limbs, More than 2 weeks significant deflection showed. Conclusion : Loss of lower limb's muscle that ensue in contracting a disease period was observed in Low Back Pain with Sciatica. The continuos studies about pathological change of lower limb in low back pain have to be perfomed.