Correlation between multifidus fatty atrophy and lumbar disc degeneration in low back pain

Cosmin Faur,Horia Haragus,Bogdan Anglitoiu,Jenel M Patrascu

doi:10.1186/s12891-019-2786-7

Cosmin Faur, Horia Haragus + Show 2 more

Open Access

https://doi.org/10.1186/s12891-019-2786-7

Copy DOI

Abstract

BackgroundChronic low back pain (LBP) is common and associated with lumbar disc herniation. The purpose of this study was to investigate if the grade of lumbar disc degeneration correlates with the degree of lumbar multifidus muscle (LMM) fatty atrophy.MethodsA retrospective analysis on 16 males and 19 females with chronic LBP and a mean age of 47.2 years. Using MRI, the grade of lumbar intervertebral discs degeneration was assessed according to the Pfirrmann classification at L4/L5 and L5/S1 levels. Fatty infiltration of the LMM was graded as normal, mild, moderate and severe. Adobe Photoshop CS6 was used for qualitative image analysis by measuring the Cross-sectional area (CSA) of the pure fat component of LMM.ResultsThere was a low correlation (R = 0.37) and significant association (ANOVA, p = 0.001, 95% CI 2.07–8.14) between the grade of lumbar disc degeneration and the degree of LMM fatty atrophy. Mean value of intervertebral disc degeneration was 2.9 for the L4/L5 level and 3.2 for L5/S1 respectively. The percentage of fat infiltration of the LMM at both studied levels showed a mean value of 22.91+/− 13.19% for L4/L5 and a higher mean value of 26.37+/− 12.89% for L5/S1. There were higher fatty atrophy scores in women and more disc degeneration in men.ConclusionThe percentage of LMM atrophy is higher in the lower levels (L5/S1) and shows a low correlation with the grade of disc degeneration.

Highlights

Chronic low back pain (LBP) is common and associated with lumbar disc herniation
T2-weighted fast spin-echo Magnetic Resonance Imaging (MRI) scans were used for the evaluation of the lumbar intervertebral discs and the lumbar multifidus muscle (LMM) as an acceptable method since these sequences were available for all patients [9, 10]
Depending on the degree of intervertebral disc degeneration, a difference between the two levels can be observed as follows: at the level L4/L5 the mean value of Pfirrmann grade was 2.9 whereas the mean value for the level L5/S1 is 3.2

Summary

Introduction

Chronic low back pain (LBP) is common and associated with lumbar disc herniation. Low back pain (LBP) is the second most common reason for seeking medical advice, with a big impact on quality of life. Chronic LBP prevalence is reported to as high as 20.3% in the adult population. It increases linearly from the third decade of life on [1]. The standard chronic LBP definition should include description of the anatomical area, pain duration and limitation level [1]. It is often associated with lumbar disc herniation.

Objectives

Methods

Results

Conclusion