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Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation.
Eur Spine J. 2016 05; 25(5):1452-1459.ES

Abstract

PURPOSE

To investigate asymmetry in size and composition of the multifidus and erector spinae in patients with posterolateral disc herniation and concordant radicular symptoms, and determine whether symptom duration is associated with degree of asymmetry.

METHODS

Thirty-three patients diagnosed with posterolateral disc herniation at L4-L5 verified on imaging and concordant leg pain were included. Multifidus and erector spinae cross-sectional area (CSA), functional cross-sectional area (FCSA, fat-free area), signal intensity and ratio of FCSA to total CSA were measured bilaterally from T 2-weighted axial magnetic resonance imaging (MRI) at L3-L4, L4-L5, L5-S1 and S1 levels.

RESULTS

No side-to-side differences in multifidus CSA, FCSA, and ratio of FCSA/CSA reached statistical significance at any spinal level. The multifidus signal intensity at L5-S1 was significantly greater (more fatty infiltration) on the side of the disc herniation. The erector spinae FCSA (lean muscle mass) at L5-S1 was found to be significantly smaller on the side of the herniation and the ratio of FCSA/CSA was smaller (more fatty infiltration) on the side of the herniation at L4-L5 and L5-S1. The degree of muscle asymmetry was not associated with symptoms duration.

CONCLUSIONS

There was no significant asymmetry of the multifidus at spinal level above, same or level below the disc herniation. Instead, variations in muscle composition were observed, with greater fat infiltration on the side and at spinal levels adjacent to the disc herniation. Muscle asymmetry was not correlated with symptom duration.

Authors+Show Affiliations

Common Spinal Disorders Research Group, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, 8205, 114 Street, Edmonton, AB, T6G 2G4, Canada.National Centre for Spinal Disorders, Budapest, Hungary.National Centre for Spinal Disorders, Budapest, Hungary.Robert Jones and Agnes Hunt Orthopaedic Hospital, Keele University, Oswestry, Shropshire, UK.Common Spinal Disorders Research Group, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, 8205, 114 Street, Edmonton, AB, T6G 2G4, Canada. michelec@ualberta.ca.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26957101

Citation

Fortin, Maryse, et al. "Paraspinal Muscle Asymmetry and Fat Infiltration in Patients With Symptomatic Disc Herniation." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 25, no. 5, 2016, pp. 1452-1459.
Fortin M, Lazáry À, Varga PP, et al. Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation. Eur Spine J. 2016;25(5):1452-1459.
Fortin, M., Lazáry, À., Varga, P. P., McCall, I., & Battié, M. C. (2016). Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 25(5), 1452-1459. https://doi.org/10.1007/s00586-016-4503-7
Fortin M, et al. Paraspinal Muscle Asymmetry and Fat Infiltration in Patients With Symptomatic Disc Herniation. Eur Spine J. 2016;25(5):1452-1459. PubMed PMID: 26957101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation. AU - Fortin,Maryse, AU - Lazáry,Àron, AU - Varga,Peter Paul, AU - McCall,Iain, AU - Battié,Michele C, Y1 - 2016/03/08/ PY - 2015/01/16/received PY - 2016/02/26/accepted PY - 2016/02/26/revised PY - 2016/3/10/entrez PY - 2016/3/10/pubmed PY - 2017/12/7/medline KW - Atrophy KW - Disc herniation KW - Erector spinae KW - Fatty infiltration KW - Multifidus SP - 1452 EP - 1459 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 25 IS - 5 N2 - PURPOSE: To investigate asymmetry in size and composition of the multifidus and erector spinae in patients with posterolateral disc herniation and concordant radicular symptoms, and determine whether symptom duration is associated with degree of asymmetry. METHODS: Thirty-three patients diagnosed with posterolateral disc herniation at L4-L5 verified on imaging and concordant leg pain were included. Multifidus and erector spinae cross-sectional area (CSA), functional cross-sectional area (FCSA, fat-free area), signal intensity and ratio of FCSA to total CSA were measured bilaterally from T 2-weighted axial magnetic resonance imaging (MRI) at L3-L4, L4-L5, L5-S1 and S1 levels. RESULTS: No side-to-side differences in multifidus CSA, FCSA, and ratio of FCSA/CSA reached statistical significance at any spinal level. The multifidus signal intensity at L5-S1 was significantly greater (more fatty infiltration) on the side of the disc herniation. The erector spinae FCSA (lean muscle mass) at L5-S1 was found to be significantly smaller on the side of the herniation and the ratio of FCSA/CSA was smaller (more fatty infiltration) on the side of the herniation at L4-L5 and L5-S1. The degree of muscle asymmetry was not associated with symptoms duration. CONCLUSIONS: There was no significant asymmetry of the multifidus at spinal level above, same or level below the disc herniation. Instead, variations in muscle composition were observed, with greater fat infiltration on the side and at spinal levels adjacent to the disc herniation. Muscle asymmetry was not correlated with symptom duration. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/26957101/Paraspinal_muscle_asymmetry_and_fat_infiltration_in_patients_with_symptomatic_disc_herniation_ L2 - https://doi.org/10.1007/s00586-016-4503-7 DB - PRIME DP - Unbound Medicine ER -