• Title/Summary/Keyword: paraspinal

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The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients (급성 및 만성 요통환자의 요부주위근 횡단면적과 요통 예후의 상관관계 연구)

  • Nam, Ji Hwan;Lee, Chong Hwan;Lee, Seul Ji;Kim, Kie Won;Lee, Min Jung;Jun, Jae Yun;Lim, Su Jin;Hong, Nam Jung;Song, Ju Hyun
    • Journal of Acupuncture Research
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    • v.30 no.4
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    • pp.45-53
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    • 2013
  • Objectives : The purpose of this study was to evaluate the relationship between cross-sectional areas of the paraspinal and psoas muscles with low back pain. Methods : We assessed the cross-sectional area of the psoas and paraspinal muscles at the superior part of L4 level and vertebral body of L4 of 132 patients who were hospitalized with a chief complaint of low back pain at Jaseng Hospital of Korean Medicine from January 2013 to April 2013. After calculating the mean psoas area, we divided the patients into 2 groups by whether the psoas cross section was larger or smaller than the mean, and compared the admission period, verbal numeric rating scale(NRS) of low back pain(LBP), and improvement of verbal NRS of LBP. We also subcategorized the patients into acute and chronic groups according to the duration period, and compared the cross-sectional area of the psoas and paraspinal muscles. Results : Although analyses of the verbal NRS of LBP, and improvement of verbal NRS of LBP between groups with larger and smaller psoas cross section areas showed no significant difference, the admission period was significantly shorter in the group with larger psoas cross section areas. There was no significant difference in analyses of cross section areas in the acute and chronic groups. Of the possible prognostic variables, improvement of verbal NRS of LBP showed no correlation, while the admission period displayed a significant correlation. The cross-sectional area of the psoas and paraspinal muscles divided by the area of the vertebral body of L4 had a significant negative correlation with age. Conclusions : The cross-sectional area of the psoas and paraspinal muscles were correlated with the admission period in LBP patients, and the cross-sectional area of the surrounding muscles divided by the area of the L4 vertebral body was negatively correlated with age.

Correlation between Fatty Infiltration of Lumbar Paraspinal Muscle and Slip Percentage on 45 Korean Medicinal Treatment Cases of Spondylolisthesis: A Retrospective Study (척추전방전위증 환자 45예의 요추주변근육의 지방침착도와 전위정도의 상관성에 대한 후향적 연구)

  • Kim, Yu-Gon;Kim, Dae-Ho;Jeong, Hyeon-Gyo;Lim, Jin-Woong;Kim, Yong-Hwa;Kang, Deok;Jeong, Hwe-Joon;Shin, Kyung-Moon;Shin, Dong-Hoon;Yang, Jae-Woo;O, Ji-Hoon;Cho, Jae-Seong
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.1
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    • pp.51-62
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    • 2022
  • Objectives Objective of this study is to investigate the role of paraspinal muscles by examining the correlation between slip percentage (SP) of spondylolisthesis and fatty infiltration of lumbar paraspinal muscle. Methods Retrospective analysis was performed on 45 patients diagnosed with spondylolisthesis based on medical records. Using T2-weighted axial magnetic resonance imaging, cross-sectional areas (CSAs) of psoas major (PM), multifidus (MU) and erector spinae (ES) were calculated and divided by CSA of lower level vertebral body (VB). SP was measured using sagittal T2-weighted images. Correlation of SP with muscle relative cross-sectional area (RCSA) and muscle fatty infiltration by Goutallier classification was respectively analyzed using Spearman correlation. Statistic assessment conducted by Wilcoxon signed rank test and paired t-test using program GraphPad prism 5 (GraphPad Software, Inc., San Diego, CA, USA). Results Spondylolisthesis forward slip percentage by Taillard's method was negatively associated with both side MU RCSAs. No significant correlation was found between PM RCSA, ES RCSA and SP. Forward slippage was significantly correlated with fatty infiltration of lumbar paraspinal muscle measured by Goutallier classification. Conclusions This study is to understand the role of paraspinal muscle affecting spinal instability by investigating correlation between statistical deviation of lumbar muscle characters (RCSA, fatty infiltration of lumbar muscle) and SP. We found that spondylolisthesis SP is positively related to fatty infiltration of lumbar paraspinal muscle. and is negatively associated with both side MU RCSAs.

Simultaneous Paraspinal and Midline Approach for Upper Lumbar Disc Herniation : Technique to Prevent Lamina Fracture

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.111-115
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    • 2005
  • Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

Effects of Spinal Stabilization Exercises on the Cross-sectional Areas of the Lumbar Multifidus and Psoas Major Muscles of Patients with Degenerative Disc Disease

  • Kim, Seong-Ho;Lee, Wan-Hee
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.9-15
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    • 2010
  • Purpose: To evaluate, in patients with degenerative disc disease (DDD), the efficacy of using spinal stabilizing exercises for the reversal? of atrophy of the multifidus and psoas major, reductions in pain and disability, and for increases in paraspinal muscle strength. Methods: Nineteen patients diagnosed with DDD participated for 10 weeks in a spinal stabilization exercise program. Pain and disability were measured before and after exercise using, respectively, a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Paraspinal muscular strength in four directions was evaluated using CENTAUR. Both before and after exercise we used computed tomography (CT) too measure cross-sectional areas (CSAs) of both the left and right multifidus and the psoas major at the upper & lower endplate of L4. Results: After 10 weeks of a spinal stabilization exercise program, pain was significantly decreased from $5.7{\pm}0.9$ to $2.5{\pm}0.9$ (p<0.01); the ODI score decreased from $16.7{\pm}4.9$ to $7.3{\pm}3.1$. Paraspinal muscle strength was significantly increased (p<0.01) and the CSAs of the left and right multifidus and psoas major muscles were significantly increased (p<0.01). Conclusion: Spinal stabilization exercise is effective in reversing atrophy in DDD patients, in reducing pain and disability, and in increasing paraspinal muscle strength. It is an effective treatment foro aiding rehabilitation in these cases.

Correlations of Cross-sectional Areas of Psoas and Paraspinal Muscles in Patients with Lumbar Disc Herniation According to the Age Groups (연령대별 요추 추간판탈출증 환자의 요근과 척추주위근 단면적에 대한 분석)

  • Kong, Deok-Hyun;Bae, Kwang-Ho;Go, Ho-Yeon;Kang, Myung-Jin;Kim, Jun-Su;Yang, Kee-Young;Lee, Jae-Hoon;Eun, Young-Jun
    • 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.

The Correlation between Cross-sectional Area of Lumbar Paraspinal Muscles and Sponylolisthesis; A Retrospective Study (요추 주변 근육 단면적과 척추전방전위증의 상관성에 대한 후향적 연구)

  • Park, Hye-Sung;Kim, Je-In;Kim, Koh-Woon;Cho, Jae-Heung;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.1
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    • pp.95-102
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    • 2016
  • Objectives To investigate correlation between slip percentage (SP) of spondylolisthesis and cross-sectional area (CSA) of lumbar paraspinal muscles; psoas major (PM), multifidus (MU) and erector spinae (ES). Methods A retrospective study was carried out in 120 spondylolisthesis patients who had visited the Spine center of Kyung Hee University Hospital at Gangdong and had taken lumbar MRI. CSA of lumbar paraspinal muscles was measured from axial T2-weighted MRI and divided by CSA of vertebral body to avoid weight's influence. SP was also measured from sagittal MRI. Results SP increase has significant correlation with decreased CSA-MU (r=0.37, p<0.01) and increased CSA-ES (r=0.19, p<0.05). There was no significant correlation between SP and CSA-PM. Conclusions MU atrophy and ES hypertrophy have significant correlation with SP of spondylolisthesis. CSA of lumbar paraspinal muscles can be a risk factor of progression of spondylolisthesis and compensation for the instability.

Effect on the facet joint tropism and lumbar paraspinal muscles according to the type of lumbar disc herniation (허리 척추사이원반 탈출 정도가 척추 후관절의 비대칭과 허리 주변근육에 미치는 영향)

  • Baek, Min-Joo;Lee, Yang-Jin;Kim, Seong-Yoel
    • Journal of Korean Physical Therapy Science
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    • v.28 no.3
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    • pp.42-52
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    • 2021
  • Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

Primary Paraspinal Malignant Peripheral Nerve Sheath Tumor

  • Kim, Kyoung-Tae;Park, Yong-Suk;Kwon, Jeong-Taik;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.91-94
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    • 2008
  • Malignant peripheral nerve sheath tumors (MPNSTs) are very rare tumors. We experienced a case of MPNST in the cervical paraspinal space which was not associated with neurofibromatosis. The tumor located in left C6-7 foramen and compressed C7 root. The tumor was removed through the occipital triangle. We report a case of the primary cerivcal MPNST in a patient who did not have neurofibromatosis-1.