• The Journal of Korean Physical Therapy
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• 제25권1호
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• pp.10-15
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• 2013

Purpose: Low back pain occurs and frequently recurs in many people. An imbalance of paraspinal muscle activity can cause low back pain. Mulligan's concept of mobilizations with sustained natural apophyseal glides (SNAG) is a common method for treating low back pain. The purpose of this study was to investigate the effects of this method on paraspinal muscle activity in patients with chronic low back pain. Methods: Twenty-one patients with low back pain participated in this study. Patients were classified using the Oswestry disability index. The subjects' paraspinal muscles were measured by surface electromyography both before and after the SNAG mobilization. We measured the root mean square value of the paraspinal muscles during lumbar flexion and extension. Results: Paraspinal muscle activity in patients with chronic low back pain was different between the right and left sides. Importantly, paraspinal muscle activity significantly decreased after using the SNAG mobilization method. Conclusion: This study shows a difference between paraspinal muscle activity in chronic low back pain patients and finds that the Mulligan's concept of SNAG mobilization is effective at reducing imbalances in paraspinal muscle activity in low back pain patients.

• 대한물리의학회지
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• 제9권3호
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• pp.271-278
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• 2014

PURPOSE: This study researched the effects of different types of high heels on the muscles surrounding the cervical spine, the thoracic spine, and the lumbar spine by analyzing muscle activation of the paraspinal muscles during walking while wearing high heels. The high heels were all of the same height: 8cm. METHODS: The 28 subjects in this experiment were females in their 20s with a foot size of 225-230mm. To measure the muscle activation of the paraspinal muscles, EMG electrodes were attached on the paraspinal muscles around C6, T7, and L5. The muscle activation during walking while wearing 8cm high wedge heels, setback heels, and french heels was measured. The measurements were performed 3 times each and the mean value of the result was used for analysis. Two kinds of velocity were used in this study. One of the velocity was 2.5 m/s. The other was 3.5 m/s. RESULTS: The muscle activation of paraspinal muscles increased significantly according to increase of walking velocity. But there was no significant difference according to the heel types. CONCLUSION: In view of the results, the height of heels and the velocity of walking are more convincing variables than the width of the heels on the muscle activation of paraspinal muscles. So wearing high heels is not recommended for those who have pain or functional problem of cervical and lumbar vertebrae.

• 한국임상수의학회지
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• 제39권6호
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• pp.334-341
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• 2022

A decrease in the paraspinal muscle cross-sectional area (CSA) and functional cross-sectional area (FCSA) are associated with low back pain and disc herniation in humans. This study examined whether chronicity or lateralization of disc herniation affects the CSA and FCSA of the paraspinal muscles. The CSA and FCSA of the paraspinal muscles between the 12th and 13th thoracic vertebrae were measured in 31 dogs with intervertebral disc herniation (IVDH). The muscle CSA and FCSA were evaluated by dividing the values of the body weight, spinal disc CSA, and spinal canal CSA to offset the differences in body type between subjects. In the chronic IVDH group, the ratio of the paraspinal muscle CSA divided by the body weight was significantly lower, and fat infiltration in the paraspinal muscle was significantly higher than in the acute group. The lateralization of the disc herniation was significantly related to the changes in the paraspinal muscle CSA. In the right-sided disc herniation group, right epaxial muscle CSA was significantly reduced compared to the left-sided disc herniation group. The change in the paraspinal muscle might be a helpful indicator to localize less obvious disc pathologies and target the search for the pathology responsible for disc-related symptoms in dogs.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.174-179
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• 2013

Objective : Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. Methods : Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. Results : Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. Conclusion : Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.88-90
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• 2006

Pneumothorax after needle electromyography is a rare complication, which usually associated with examination of diaphragmatic and intercostal muscles. However, by the literatures, it can also occur with supraspinatus, serratus anterior and paraspinal muscles. We experienced a case of pneumothorax after cervical paraspinal muscle needle electromyography. From the anatomical vulnerability of pneumothorax during needle insertion, we emphasized the importance of avoiding this complication.

• The Korean Journal of Pain
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• 제34권4호
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• pp.454-462
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• 2021

Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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• pp.430-436
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• 2016

Objective : The objective of this study is to establish an animal model of chronic paraspinal muscle injury in rat. Methods : Fifty four Sprague-Dawley male rats were divided into experimental group (n=30), sham (n=15), and normal group (n=9). Incision was done from T7 to L2 and paraspinal muscles were detached from spine and tied at each level. The paraspinal muscles were exposed and untied at 2 weeks after surgery. Sham operation was done by paraspinal muscles dissection at the same levels and wound closure was done without tying. Kyphotic index and thoracolumbar Cobb's angle were measured at preoperative, 2, 4, 8, and 12 weeks after the first surgery for all groups. The rats were sacrificed at 4, 8, and 12 weeks after the first surgery, and performed histological examinations. Results : At 4 weeks after surgery, the kyphotic index decreased, but, Cobb's angle increased significantly in the experimental group (p<0.05), and then that were maintained until the end of the experiment. However, there were no significant differences of the kyphotic index and Cobb's angle between sham and normal groups. In histological examinations, necrosis and fibrosis were observed definitely and persisted until 12 weeks after surgery. There were also presences of regenerated muscle cells which nucleus is at the center of cytoplasm, centronucleated myofibers. Conclusion : Our chronic injury model of paraspinal muscles in rats shows necrosis and fibrosis in the muscles for 12 weeks after surgery, which might be useful to study the pathophysiology of the degenerative thoracolumbar kyphosis or degeneration of paraspinal muscles.

• 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.

• 한방재활의학과학회지
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• 제20권4호
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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.

• 한방재활의학과학회지
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• 제32권1호
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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.