Maryse Fortin1, Àron Lazáry2, Peter Paul Varga2, Michele C Battié3. 1. PERFORM Centre, Concordia University, 7200 Sherbrooke West Street, PC 2.209, Montreal, QC, H4B 1R6, Canada. maryse.fortin@concordia.ca. 2. National Centre for Spinal Disorders, Királyhágó u. 1, Budapest, 1126, Hungary. 3. Common Spinal Disorders Research Group, Faculty of Rehabilitation Medicine, University of Alberta, 8205-114 Street, Edmonton, AB, T6G 2G4, Canada.
Abstract
PURPOSE: Lumbar spinal stenosis (LSS) is a disabling condition associated with narrowing of the spinal canal or vertebral foramina. Paraspinal muscle atrophy and fatty infiltration have been reported in patients with chronic LBP and disc herniation. However, very few imaging studies have examined paraspinal muscle morphology and composition in patients with LSS. The purpose of this study was to investigate the association of paraspinal muscle size, composition and asymmetry with functional status in patients with LSS. METHODS: Thirty-six patients diagnosed with LSS at L4-L5 with neurogenic claudication were included. Paraspinal muscle measurements were obtained from axial T2-weighted MR images, bilaterally, at the level of the superior and inferior vertebral endplates of L5. Muscle measurements of interest included: total cross-sectional area (CSA), functional CSA (FCSA), the ratio of FCSA to CSA (FCSA/CSA) as an indicator of muscle composition, and relative % asymmetry in muscle CSA. The association between muscle parameters and other patient characteristics with function as indicated from Oswestry Disability Index (ODI) scores and pain interference status was investigated. RESULTS: Greater multifidus muscle fatty infiltration (e.g., lower FCSA/CSA) and lower psoas relative CSA were associated with lower function (higher ODI and pain interference scores) in univariable and multivariable analyses. There was no association between the different muscle parameters and stenosis severity or back or leg pain duration or severity. CONCLUSIONS: Our findings suggest an association of multifidus muscle fatty infiltration and psoas muscle size with functional status in patients diagnosed with LSS. Future prospective studies are needed to evaluate whether such muscle parameters are associated with prognosis and functional recovery following surgical treatment.
PURPOSE:Lumbar spinal stenosis (LSS) is a disabling condition associated with narrowing of the spinal canal or vertebral foramina. Paraspinal muscle atrophy and fatty infiltration have been reported in patients with chronic LBP and disc herniation. However, very few imaging studies have examined paraspinal muscle morphology and composition in patients with LSS. The purpose of this study was to investigate the association of paraspinal muscle size, composition and asymmetry with functional status in patients with LSS. METHODS: Thirty-six patients diagnosed with LSS at L4-L5 with neurogenic claudication were included. Paraspinal muscle measurements were obtained from axial T2-weighted MR images, bilaterally, at the level of the superior and inferior vertebral endplates of L5. Muscle measurements of interest included: total cross-sectional area (CSA), functional CSA (FCSA), the ratio of FCSA to CSA (FCSA/CSA) as an indicator of muscle composition, and relative % asymmetry in muscle CSA. The association between muscle parameters and other patient characteristics with function as indicated from Oswestry Disability Index (ODI) scores and pain interference status was investigated. RESULTS: Greater multifidus muscle fatty infiltration (e.g., lower FCSA/CSA) and lower psoas relative CSA were associated with lower function (higher ODI and pain interference scores) in univariable and multivariable analyses. There was no association between the different muscle parameters and stenosis severity or back or leg pain duration or severity. CONCLUSIONS: Our findings suggest an association of multifidus muscle fatty infiltration and psoas muscle size with functional status in patients diagnosed with LSS. Future prospective studies are needed to evaluate whether such muscle parameters are associated with prognosis and functional recovery following surgical treatment.
Authors: Michael A Fischer; Daniel Nanz; Caecilia S Reiner; Matteo Montani; Stefan Breitenstein; Sebastian Leschka; Hatem Alkadhi; Paul Stolzmann; Borut Marincek; Hans Scheffel Journal: Invest Radiol Date: 2010-08 Impact factor: 6.016
Authors: Young Uk Kim; Yu-Gyeong Kong; Jonghyuk Lee; Yuseon Cheong; Se hun Kim; Hyun Kyu Kim; Jun Young Park; Jeong Hun Suh Journal: Eur Spine J Date: 2015-08-21 Impact factor: 3.134
Authors: Martin J Willemink; Hendrik W van Es; Pieter H Helmhout; Arjen L Diederik; Johannes C Kelder; Johannes P M van Heesewijk Journal: Spine (Phila Pa 1976) Date: 2012-12-15 Impact factor: 3.468
Authors: Marjolein Visser; Stephen B Kritchevsky; Bret H Goodpaster; Anne B Newman; Michael Nevitt; Elizabeth Stamm; Tamara B Harris Journal: J Am Geriatr Soc Date: 2002-05 Impact factor: 5.562
Authors: Hasan Banitalebi; Jørn Aaen; Kjersti Storheim; Anne Negård; Tor Åge Myklebust; Margreth Grotle; Christian Hellum; Ansgar Espeland; Masoud Anvar; Kari Indrekvam; Clemens Weber; Jens Ivar Brox; Helena Brisby; Erland Hermansen Journal: Eur Radiol Exp Date: 2022-07-20