Abstract

BackgroundPrevious studies suggested that patients with symptomatic intervertebral disc degeneration (IDD) of lumbar spine have reduced cross-sectional area (CSA) and functions of core muscles. However, reduced CSA and functions of core muscles have been observed not only in patients with symptomatic IDD but also in patients with other subgroups of low back pain (LBP). Thus, it is uncertain whether reduced CSA and functions of core muscles lead to IDD and LBP, or pain leads to reduced CSA and functions of core muscles in patients with symptomatic IDD. Therefore, this study aimed to compare the CSA and functions of core muscles between asymptomatic participants with and without IDD in magnetic resonance imaging (MRI).MethodsTwenty asymptomatic participants (12 men and 8 women) participated in this study. Ten participants had asymptomatic IDD at L4–5. The others were healthy controls (without IDD at all levels of lumbar spine). The CSA of core muscles was measured using MRI. Maximal isometric trunk flexor strength and side bridge strength were measured by a Smart KEMA strength sensor. Trunk flexor endurance test, side bridge endurance test and plank endurance test were used to measure core endurance. Double legs loading test was used to measure core stability. Mann-Whitney U test was used to compare the differences between two groups.ResultsThere were no significant differences in core muscle functions between the two groups (p > 0.05). Moreover, there was no significant difference in CSA between the two groups (p > 0.05).ConclusionsThere was no significant difference in CSA and core muscle functions between asymptomatic participants with and without IDD. These findings indicate that a degenerative or bulging disc in asymptomatic individuals has little effect on CSA and functions of core muscles, especially in young age. Therefore, the general core endurance test or strength test could not differentiate asymptomatic people with and without IDD of lumbar spine.Trial registration numberClinical Research information Service. KCT0004061. Registered 13 June 2019. retrospectively registered.

Highlights

  • Previous studies suggested that patients with symptomatic intervertebral disc degeneration (IDD) of lumbar spine have reduced cross-sectional area (CSA) and functions of core muscles

  • Induced pain on paraspinal muscles after hypertonic saline injections could cause reduced muscle activity [24, 25]. It is uncertain whether reduced CSA and functions of core muscles lead to IDD and low back pain (LBP), or pain leads to reduced CSA and functions of core muscles in patients with symptomatic IDD

  • There were no significant differences in core muscle functions between the two groups (p > 0.05) (Table 2)

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Summary

Introduction

Previous studies suggested that patients with symptomatic intervertebral disc degeneration (IDD) of lumbar spine have reduced cross-sectional area (CSA) and functions of core muscles. Reduced CSA and functions of core muscles have been observed in patients with symptomatic IDD and in patients with other subgroups of low back pain (LBP). This study aimed to compare the CSA and functions of core muscles between asymptomatic participants with and without IDD in magnetic resonance imaging (MRI). Intervertebral disc degeneration (IDD) of the lumbar spine is an underlying factor of low back pain (LBP) [1]. Magnetic resonance imaging (MRI) is the most widely used method for clinical assessment of IDD of the lumbar spine [2, 3]. Muscle force imbalance may lead to kinetic instability of the spine, a possible reason for LBP [16]

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