• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.109-117
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• 2021

Purpose: To investigate the reliability of CT and MRI for quantitative and qualitative analyses of lumbar paraspinal muscle fatty infiltration (PSFI) and correlation of PSFI with intervertebral disc pathology. Materials and Methods: Lumbar spine CT and MRI of 36 subjects were reviewed retrospectively. Two observers independently outlined lumbar paraspinal muscles at each mid-intervertebral disc level. Paraspinal muscles on CT and MRI were graded according to the Goutallier grading system (GGS). The area, mean value, and standard deviation (SD) of the Hounsfield unit (HU) were obtained. Intervertebral discs were assessed on axial image of T2WI at each level. Correlations between qualitative and quantitative data and intervertebral disc pathology, age, and sex were evaluated. Results: Inter- and intra-observer agreements for results of GGS on MRI were substantial (κ = 0.79) and moderate (κ = 0.59), respectively. Inter- and intra-observer agreements for results of GGS on CT were almost perfect (κ = 0.88) and substantial (κ = 0.66), respectively. Quantitative measurements of HU showed almost perfect inter- and intra-observer reliabilities (κ = 0.82 and κ = 0.99, respectively). There were statistically significant correlations between intervertebral disc pathology and PSFI at L1-2, L2-3, and L4-5 levels on MRI and at L1-2 and L3-4 levels on CT. Age showed significant correlation with results of GGS at all levels on CT and MRI. Conclusion: This study showed that GGS results and HU measurements could be useful for evaluating PSFI because they showed correlations with intervertebral disc pathology results at certain levels.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.06a
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• pp.229-230
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• 2008

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.329-334
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• 2022

Objective: Low back pain (LBP) is a symptom that accounts for a large proportion of musculoskeletal pain. Among them, non-specific LBP (NSLBP) means that the pathological cause is unknown, and belongs to the most common LBP. Studies on the mechanism of muscle control in LBP are insufficient, and quantitative studies are needed. Design: Observational cross-sectional study design Methods: A Thirty participants with NSLBP symptoms were enrolled, and their pressure pain thresholds (PPT) and muscle and fat thickness were measured. Participants measured the paraspinal muscles (PM) of the thoracic and lumbar spine and medial hamstring (semitendinosus) on the dominant and non-dominant sides in the prone position. Results: Among the variables that were significant in the correlation analysis, PM of the thoracic and lumbar spine showed a significant relationship in the PPT ([thoracic spine PM]=1.141+0.912 [lumbar spine PM]). Also, there was a significant relationship between the lumbar spine PM in the PPT and the thoracic spine PM in the muscle thickness ([lumbar spine PM of PPT]=4.057+0.117 [thoracic spine PM of muscle thickness]) Conclusions: Although there was no muscle imbalance according to the dominant and non-dominant side, there is a correlation between the pressure pain threshold and the muscle thickness between the paraspinal muscles of the thoracic spine and the lumbar spine.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.566-570
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• 2015

Intramuscular myxoma (IM) is a benign neoplasm of mesenchymal origin. We report a rare case of IM which was located in the lumbosacral paraspinal muscles. A 62-year-old female patient presented with progressive low back pain for 2 months, and the radiologic findings showed a large mass ($4.0{\times}3.5{\times}6.5cm$) in the right lumbosacral paraspinal area. Total resection of the tumor was performed and the symptom was nearly resolved after surgery. Although the immuno-histopathological analysis was consistent with IM, there were some different findings from typical pathological characteristics of IM in this case. Firstly, the symptomatic change of the mass took relatively short time (less than 3 months), and this change was accompanied by partial calcification inside the mass. Moreover, iatrogenic interruption of paravertebral muscle by the other previous operation might be the promoting factor of the fibrous dysplasia, which can explain the pathogenesis of IM. To our knowledge, this is the eighth case of the lumbar paraspinal myxoma reported in the literatures and the first case in Asian population.

• The Journal of Korean Physical Therapy
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• v.6 no.1
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• pp.17-22
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• 1994

The purpose of this study were to identify the correlation of shoulder pain to Cervical Pathology and effectiveness of Cervical treatment on the neck and shoulder. Sixty patients complaining of shoulder pain only without neck pain were evaluated by physical examination. Cervical X- rays and electrodiagnostic Study. The results were as follows: 1) Forty nine Cases were abnormal in plain Cervical spine X-ray with straightening of Cervical lordotic curve in 41 cases, Cervical spondybsis 16 cases and disc space narrowing in 4 cases. 2) Cervical radiculopathies were diagnosed 52 cases which showed abnormal spontaneous activities in needle. EMG : 26 cases in paraspinal muscles and 26 cases in both paraspinal and upper extremity muscles. 3) The results of treatment were excellent in 6 cases, good in 6 cases and fair in 32 cases. 4) Treatment side were effective with shoulder and conical in 36 cases.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.4
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• pp.255-260
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• 2008

Purpose : This study was performed to find out the influence of the change on proprioception and coordination of the lower limb by experimentally induced paraspinal muscle fatigue, Methods : Twelve subjects(6 males, 6 females) with no history low back and lower limbs problem volunteered for this study. Subjects were pre-tested proprioception and coordination using the MR-FSS(Mornitored Rehab Functional Squat System). And then the subjects performed isometric paraspinal muscles contraction for induced muscle fatigue. Muscle fatigue was defined surface EMG(MP 150). After isometric contraction, the subjects were post-tested using the MR-FSS. Results : In comparison of coordination, deviation of concentric coordination was increased(from $0.50{\pm}0.13cm$ to $0.67{\pm}0.21$)(p<0.05) and deviation of eccentric coordination was also increased(from $0.51{\pm}0.15cm$ to $0.70{\pm}0.26cm$)(p<0.05). And deviation movement of proprioceptive test was increased(from $4.98{\pm}1.80cm$ to $5.69{\pm}1.98cm$), but there was no significant different(p>0.05). Conclusion : Fatigue of paraspinal muscles was decreased concentric and eccentric coordination of the lower limb.

• Physical Therapy Korea
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• v.16 no.3
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• pp.16-23
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• 2009

The purpose of this study was to investigate the effects of a repetitive lifting task on the level of activation and median frequency of the paraspinal muscles, and to provide basic data of the maximal acceptable duration of the lifting task to avoid muscle fatigue. Ten healthy male subjects were recruited as participants and they repetitively (12 lifts/min) lifted a box ($46cm{\times}30cm{\times}30cm$, 15 kg) for 10 minutes. Electromyographic data (muscle activation and median frequency), heart rate, and Borg CR10 score were recorded at 1, 3, 5, 7, and 9 minutes after the lifting task. Electromyographic data was recorded from the elector spinalis, mutifidus, external oblique abdominis, and rectus abdominis for 1 minute. The results showed that as the repetitive lifting task progressed, the heart rate and Borg CR10 score significantly increased. In addition, activation of the muscles increased. The median frequency significantly decreased over time in the elector spinalis, mutifidus, and external oblique abdominis (right side), except for the external oblique abdominis (left side) and rectus abdominis. It is suggested that the median frequency recorded from a dynamic task is used to monitor muscle fatigue. Furthermore, the repetitive lifting task (15 kg, 12 lifts/min) should not continue for more than 3 minutes in order to avoid muscle fatigue.

• Physical Therapy Korea
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• v.11 no.4
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• pp.19-29
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• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.135-143
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• 2009

Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.4
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• pp.159-169
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• 2010

Objectives : This study was designed to evaluate the correlation of the cross-sectional areas(CSA) of paraspinalis(iliocostalis lumborum, multifidus, longissimus thoracis parts lumborum) and psoas muscle and sex, age, change of the VAS(visual analogue scale) and past history of chronic low back pain in patients suffering from HIVD(herniation of intervertebral disc). Methods : Medical records of 140 subjects with HIVD were retrospectively reviewed. The MRI(magnetic resonance imaging) findings on the patients were scanned and analyzed by PiView program to find the paraspinal and psoas muscle CSA and were evaluated by the correlation of sex, age, change of the VAS, and past history of chronic low back pain. Results : There was significant difference between groups in male and female, young-adults age and middle age, middle age and old age, young-adults age and old age. But the correlation of the paraspinal and psoas muscle CSA and past history of chronic low back pain were partially significant. On the other hand, the correlation of the paraspinal and psoas muscle CSA and change of the VAS were not significant. Conclusions : These results suggest that the cross-sectional areas(CSA) of paraspinalis and psoas muscle have relevance to sex and age.