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Zhongguo Xiu Fu Chong Jian Wai Ke Za... Nov 2020To review the evaluation method of paraspinal muscle and its role in lumbar spine diseases, and offer reference for further research on paraspinal muscles.
OBJECTIVE
To review the evaluation method of paraspinal muscle and its role in lumbar spine diseases, and offer reference for further research on paraspinal muscles.
METHODS
The related literature of paraspinal muscle measurement and its role in lumbar spine diseases was reviewed. The evaluation methods of paraspinal muscle were analyzed from the advantages and disadvantages and the role of paraspinal muscle in lumbar spine diseases was summarized.
RESULTS
Radiographic methods are often used to evaluate the atrophy of paraspinal muscle, mainly including CT and MRI. The cross-sectional area and fatty infiltration of paraspinal muscle are two key parameters. Radiographic methods are reproducible and widely applied, but CT has the disadvantage of radiation exposure, while the cost of MRI is high. Besides, more and more researchers focus on the functional evaluation of paraspinal muscle, which mainly includes surface electromyogram analysis and back muscle strength test. The surface electromyogram analysis can quantitatively measure neuromuscular function, but the results could be affected by many influencing factors. The back muscle strength test is simple, but it lacks standardized posture. The atrophy of paraspinal muscle is related to many lumbar spine diseases, while the results of different researches are different.
CONCLUSION
There are many methods to evaluate paraspinal muscles, but there is no unified standard. The role of paraspinal muscle in lumbar spine diseases need to be further studied.
Topics: Electromyography; Lumbar Vertebrae; Lumbosacral Region; Magnetic Resonance Imaging; Paraspinal Muscles
PubMed: 33191707
DOI: 10.7507/1002-1892.201912120 -
Study on Risk Factors of Primary Non-traumatic OVCF in Chinese Elderly and a Novel Prediction Model.Orthopaedic Surgery Nov 2022Prevention of fragility fractures is one of the public health priorities worldwide, whilst the incidence of osteoporotic vertebral compression fractures (OVCF) continues...
OBJECTIVE
Prevention of fragility fractures is one of the public health priorities worldwide, whilst the incidence of osteoporotic vertebral compression fractures (OVCF) continues to rise and lacks the corresponding accurate prediction model. This study aimed to screen potential causes and risk factors for primary non-traumatic osteoporotic vertebral compression fractures (NTOVCF) in the elderly by characterizing a patient population with NTOVCF and comparing it with a population of osteoporotic patients.
METHODS
Between January 2013 and January 2022, 208 elderly patients with unequivocal evidence of bone fragility manifested as painful NTOVCF were enrolled, and compared with 220 patients with osteoporosis and no fractures. The demographic data, bone turnover markers, blood routine, serum biochemical values, and radiological findings were investigated. Differences between the fracture and non-fracture groups were analyzed, and variables significant in univariate analysis and correlation analysis were included in the logistic analysis to build the risk prediction model for osteoporotic vertebral fractures. Univariate analysis using student's t-tests for continuous variables or a chi-squared test for categorical variables was conducted to identify risk factors.
RESULTS
No significant differences were revealed regarding age, gender, BMI, smoking, alcohol consumption, blood glucose, propeptide of type I procollagen (P1NP), and N-terminal middle segment osteocalcin (N-MID) (P > 0.05). Parathyroid Hormone (PTH), 25(OH)D, serum albumin (ALB), hemoglobin (HB), bone mineral density (BMD), and cross-sectional area (CSA) of the paraspinal muscle in the fracture group were significantly lower than those in the control group; however, b-C-terminal telopeptide of type I collagen (β-CTX), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), non-prostatic acid phosphatase (NACP), and fatty degeneration ratio (FDR) were significantly higher than those in the control group (P < 0.05). Logistic regression analysis showed that ALB, HB, CSA, and BMD were negatively correlated with NTOVCF, while β-CTX, HDL-C, NACP, and FDR were positively correlated with NTOVCF.
CONCLUSION
Decreased physical activity, anemia, hypoproteinemia, imbalances in bone metabolism, abnormal lipid metabolism, and degenerative and decreased muscle mass, were all risk factors for OVCF in the elderly, spontaneous fractures may be the consequence of cumulative declines in multiple physiological systems over the lifespan. Based on this risk model, timely detection of patients with high OVCF risk and implementation of targeted preventive measures is expected to improve the effect of fracture prevention.
Topics: Female; Humans; Aged; Fractures, Compression; Osteoporosis, Postmenopausal; Spinal Fractures; Osteoporotic Fractures; Bone Density; Bone Diseases, Metabolic; Risk Factors; China; Cholesterol
PubMed: 36168985
DOI: 10.1111/os.13531 -
BMC Musculoskeletal Disorders Jul 2023Fat infiltration (FI) of the deep neck extensor muscles has been shown to be associated with poor outcomes in cervical injury, mechanical neck pain, and axial symptoms...
PURPOSE
Fat infiltration (FI) of the deep neck extensor muscles has been shown to be associated with poor outcomes in cervical injury, mechanical neck pain, and axial symptoms after cervical spine surgery. However, information is scarce on the severity of FI in cervical extensors associated with different clinical syndromes in patients with cervical spondylosis.
OBJECTIVE
To investigate the relationship between the severity of FI in the cervical multifidus musculature and its clinical correlates in the syndromes and sagittal alignment of patients with cervical spondylosis.
METHODS
This study was conducted as a retrospective study of twenty-eight healthy volunteers (HV) together with sixty-six patients who underwent cervical radiculopathy (CR), degenerative myelopathy (DM), and axial joint pain (AJP) from January 2020 to March 2022. MRI was used to measure the fat cross-sectional area (FCSA), functional muscle cross-sectional area (FMCSA), total muscle cross-sectional area (TMCSA), FI ratio of the cervical multifidus musculature at each cervical level from the C3 to C6 segments and the cervical lordosis angle in the included subjects.
RESULTS
The difference in the FCSA and FI ratio in patient groups with cervical spondylosis was significantly greater than that of the HV group (P < 0.05), and the Cobb angle of the DM group, AJP group and HV group was significantly greater than that of the CR group (P < 0.05). The FI ratio comparison showed no significant difference by sex, and the comparison of FCSA, FMCSA, TMCSA and FI ratio showed no significant difference by age range from 35 to 69 in the included subjects. The FCSA and TMCSA in patients with cervical spondylosis were positively related to the Cobb angle (r= 0.336, P = 0.006, r =0.319, P = 0.009, respectively), and the FI ratio was inversely correlated with the Cobb angle (r= -0.285, P = 0.020) and positively correlated with age (r =0.261, P = 0.034). In the HV group, FMCSA was inversely correlated with age (r= -0.400, P = 0.035), while the FI ratio had a positive correlation with age (r= -0.423, P = 0.025).
CONCLUSION
Compared with healthy subjects, a more severe degree of FI in the multifidus musculature and sagittal imbalance were found in patients with cervical spondylosis. These two imaging features are considered to be important concomitant phenomena of cervical spondylosis, and the more severe FI is, the worse the sagittal imbalance. However, each syndrome had no obvious difference in FI in the multifidus musculature.
Topics: Humans; Retrospective Studies; Paraspinal Muscles; Syndrome; Cervical Vertebrae; Radiculopathy; Spondylosis
PubMed: 37501110
DOI: 10.1186/s12891-023-06595-4 -
Frontiers in Physiology 2022Microgravity induces spinal elongation and Low Back Pain (LBP) but the pathophysiology is unknown. Changes in paraspinal muscle viscoelastic properties may play a role....
Microgravity induces spinal elongation and Low Back Pain (LBP) but the pathophysiology is unknown. Changes in paraspinal muscle viscoelastic properties may play a role. Dry Immersion (DI) is a ground-based microgravity analogue that induces changes in m. superficial myofascial tissue tone within 2 h. This study sought to determine whether bilateral m. tone, creep, and stiffness persist beyond 2 h; and if such changes correlate with DI-induced spinal elongation and/or LBP. Ten healthy males lay in the DI bath at the Institute of Biomedical Problems (Moscow, Russia) for 6 h. Bilateral lumbar (L1, L4) and thoracic (T11, T9) trunk myofascial tone, stiffness and creep (MyotonPRO), and subjective LBP (0-10 NRS) were recorded before DI, after 1h, 6 h of DI, and 30min post. The non-standing spinal length was evaluated on the bath lifting platform using a bespoke stadiometer before and following DI. DI significantly modulated m. viscoelastic properties at L4, L1, T11, and T9 with no effect of laterality. Bilateral tissue tone was significantly reduced after 1 and 6 h DI at L4, L1, T11, and T9 to a similar extent. Stiffness was also reduced by DI at 1 h but partially recovered at 6 h for L4, L1, and T11. Creep was increased by DI at 1 h, with partial recovery at 6 h, although only T11 was significant. All properties returned to baseline 30 min following DI. Significant spinal elongation (1.17 ± 0.20 cm) with mild (at 1 h) to moderate (at 6 h) LBP was induced, mainly in the upper lumbar and lower thoracic regions. Spinal length increases positively correlated (Rho = 0.847, = 0.024) with middle thoracic (T9) tone reduction, but with no other stiffness or creep changes. Spinal length positively correlated (Rho = 0.557, = 0.039) with Max LBP; LBP failed to correlate with any m. measured parameters. The DI-induced bilateral m. tone, creep, and stiffness changes persist beyond 2 h. Evidence of spinal elongation and LBP allows suggesting that the trunk myofascial tissue changes could play a role in LBP pathogenesis observed in real and simulated microgravity. Further study is warranted with longer duration DI, assessment of IVD geometry, and vertebral column stability.
PubMed: 36311233
DOI: 10.3389/fphys.2022.1039924 -
JOR Spine Sep 2020MRI derived spinal-muscle morphology measurements have potential diagnostic, prognostic, and therapeutic applications in spinal health. Muscle morphology in the thoracic...
OBJECTIVE
MRI derived spinal-muscle morphology measurements have potential diagnostic, prognostic, and therapeutic applications in spinal health. Muscle morphology in the thoracic spine is an important determinant of kyphosis severity in older adults. However, the literature on quantification of spinal muscles to date has been limited to cervical and lumbar regions. Hence, we aim to propose a method to quantitatively identify regions of interest of thoracic spinal muscle in axial MR images and investigate the repeatability of their measurements.
METHODS
Middle (T4-T5) and lower (T8-T9) thoracic levels of six healthy volunteers (age 26 ± 6 years) were imaged in an upright open scanner (0.5T MROpen, Paramed, Genoa, Italy). A descriptive methodology for defining the regions of interest of trapezius, erector spinae, and transversospinalis in axial MR images was developed. The guidelines for segmentation are laid out based on the points of origin and insertion, probable size, shape, and the position of the muscle groups relative to other recognizable anatomical landmarks as seen from typical axial MR images. 2D parameters such as muscle cross-sectional area (CSA) and muscle position (radius and angle) with respect to the vertebral body centroid were computed and 3D muscle geometries were generated. Intra and inter-rater segmentation repeatability was assessed with intraclass correlation coefficient (ICC (3,1)) for 2D parameters and with dice coefficient (DC) for 3D parameters.
RESULTS
Intra and inter-rater repeatability for 2D and 3D parameters for all muscles was generally good/excellent (average ICC (3,1) = 0.9 with ranges of 0.56-0.98; average DC = 0.92 with ranges from 0.85-0.95).
CONCLUSION
The guidelines proposed are important for reliable MRI-based measurements and allow meaningful comparisons of muscle morphometry in the thoracic spine across different studies globally. Good segmentation repeatability suggests we can further investigate the effect of posture and spinal curvature on muscle morphology in the thoracic spine.
PubMed: 33015576
DOI: 10.1002/jsp2.1103 -
Progress in Rehabilitation Medicine 2020The purpose of this study was to examine the relationships between intervertebral disc degeneration in the lumbar spine, paraspinal muscle morphology, and clinical...
OBJECTIVE
The purpose of this study was to examine the relationships between intervertebral disc degeneration in the lumbar spine, paraspinal muscle morphology, and clinical features in patients with lumbar spinal stenosis (LSS).
METHODS
A total of 52 patients with LSS participated in this study. Magnetic resonance imaging was used to assess intervertebral disc degeneration at L4/5 and to measure the standardized cross-sectional areas (SCSAs) of the multifidus and erector spinae muscles. The intensity of low back pain (LBP) and lower limb pain, the level of disability, and the quality of life (QoL) were evaluated using patient-reported outcome measures. The associations between the image findings and clinical features, including the disability score, the pain score for low back pain, and the QoL score, were calculated using Spearman's rank correlation coefficient.
RESULTS
No associations were found between disc degeneration and clinical features. However, disc degeneration and the SCSA of the multifidus muscle (=-0.38, P <0.01) and of the erector spinae muscle (=-0.29, P=0.04) were significantly associated. Analysis of the associations between muscle morphology and clinical features found that the SCSA of the multifidus muscle was associated with LBP (=0.31, P=0.03).
CONCLUSIONS
These results suggest that there is some correlation between atrophy of the multifidus and pain intensity. Consequently, focusing on the CSA of the multifidus muscle may help to clarify the causes of LBP in patients with LSS. However, because of the cross-sectional nature of this study, causal relationships could not be determined and further research is needed.
PubMed: 32844128
DOI: 10.2490/prm.20200015 -
Quantitative Imaging in Medicine and... Feb 2020Paraspinal musculature forms one of the largest muscle compartments of the human body, but evidence for regional variation of its composition and dependency on gender or...
BACKGROUND
Paraspinal musculature forms one of the largest muscle compartments of the human body, but evidence for regional variation of its composition and dependency on gender or body mass index (BMI) is scarce.
METHODS
This study applied six-echo chemical shift encoding-based water-fat magnetic resonance imaging (MRI) at 3 Tesla in 76 subjects (24 males and 52 females, age: 40.0±13.7 years, BMI: 25.4±5.6 kg/m) to evaluate the proton density fat fraction (PDFF) of psoas muscles and erector spinae muscles, with the latter being divided into three segments in relation to levels of spine anatomy (L3-L5, T12-L2, and T9-T11).
RESULTS
For the psoas muscles and the erector spinae muscles (L3-L5), gender differences in PDFF values were observed (PDFF psoas muscles: males: 5.1%±3.4% . females: 6.0%±2.2%, P=0.006; PDFF erector spinae muscles L3-L5: males: 10.7%±7.6% . females: 18.2%±6.8%, P<0.001). Furthermore, the PDFF of the erector spinae muscles (L3-L5) showed higher PDFF values when compared to the other segments (PDFF erector spinae muscles L3-L5 . T12-L2: P<0.001; PDFF erector spinae muscles L3-L5 . T9-T11: P<0.001) and showed to be independent of BMI, which was not the case for the other segments (T12-L2 or T9-T11) or the psoas muscles. When considering age and BMI as control variables, correlations of PDFF between segments of the erector spinae muscles remained significant for both genders.
CONCLUSIONS
This study explored regional variation of paraspinal muscle composition and dependency on gender and BMI, thus offering new insights into muscle physiology. The PDFF of the erector spinae muscles (L3-L5) was independent of BMI, suggesting that this level may be suited for representative paraspinal muscle segmentation and PDFF extraction as a biomarker for muscle alterations in the future.
PubMed: 32190574
DOI: 10.21037/qims.2020.01.10 -
BMC Musculoskeletal Disorders Oct 2023The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a...
Fat infiltration of the posterior paraspinal muscles is inversely associated with the fat infiltration of the psoas muscle: a potential compensatory mechanism in the lumbar spine.
BACKGROUND
The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a hip flexor, the psoas muscle and its complex anatomy suggest that the muscle has other functions involved in stabilizing the lumbar spine. The aim of this study is to determine how the psoas muscle and the posterior paraspinal muscles (PPM; erector spinae and multifidus) interact with each other.
METHODS
A retrospective review including patients undergoing posterior lumbar fusion surgery between 2014 and 2021 at a tertiary care center was conducted. Patients with a preoperative lumbar magnetic resonance imaging (MRI) scan performed within 12 months prior to surgery were considered eligible. Exclusion criteria included previous spinal surgery at any level, lumbar scoliosis with a Cobb Angle > 20° and patients with incompatible MRIs. MRI-based quantitative assessments of the cross-sectional area (CSA), the functional cross-sectional area (fCSA) and the fat area (FAT) at L4 was conducted. The degree of fat infiltration (FI) was further calculated. FI thresholds for FI were defined according to literature and patients were divided into two groups (< or ≥ 50% FI).
RESULTS
One hundred ninetypatients (57.9% female) with a median age of 64.7 years and median BMI of 28.3 kg/m met the inclusion criteria and were analyzed. Patients with a FI ≥ 50% had a significantly lower FI in the psoas muscle in both sexes. Furthermore, a significant inverse correlation was evident between FI and FI for both sexes. A significant positive correlation between FAT and fCSA was also found for both sexes. No significant differences were found for both sexes in both FI groups.
CONCLUSION
As the FI increases, the FI decreases. Increased FI is a surrogate marker for a decrease in muscular strength. Since the psoas and the PPM both segmentally stabilize the lumbar spine, these results may be indicative of a potential compensatory mechanism. Due to the weakened PPM, the psoas may compensate for a loss in strength in order to stabilize the spine segmentally.
Topics: Male; Humans; Female; Middle Aged; Paraspinal Muscles; Psoas Muscles; Lumbar Vertebrae; Lumbosacral Region; Retrospective Studies; Magnetic Resonance Imaging
PubMed: 37891498
DOI: 10.1186/s12891-023-06967-w -
PloS One 2021The objective of this study were to examine the effects of diets containing spineless cactus associated with hays of different legume species [gliricidia (Gliricidia...
The objective of this study were to examine the effects of diets containing spineless cactus associated with hays of different legume species [gliricidia (Gliricidia sepium), "catingueira" (Caesalpinia bracteosa), "sabiá" (Mimosa caesalpiniifolia Benth) and "catanduva" (Piptadenia moniliformis Benth)] on the intake, digestibility, performance and carcass traits of lambs. Twenty-four ½ Santa Inês × ½ Soinga lambs with an average body weight of 21.4 ± 2.53 kg were distributed into four treatments in a completely randomized design. Treatments consisted of diets formulated with the association of spineless cactus (Opuntia ficus-indica Mill) and hay of four legume species, namely, "catanduva", "sabiá" "catingueira" and gliricidia. The lowest intakes (P<0.05) of dry matter (DM), organic matter (OM), neutral detergent fiber (NDF) and total carbohydrates occurred in the animals that received the diet containing catingueira hay. However, there were no diet effects (P>0.05) on the intakes of crude protein (CP), ether extract and non-fibrous carbohydrates. The diets also did not change (P>0.05) the weight gain (0.197 kg/day) or final weight (33.18 kg) of the lambs or the apparent digestibility coefficients of DM, OM, CP and NDF. Consequently, the parameters of live weight at slaughter (34.10 kg), hot carcass weight (14.81 kg), cold carcass weight (14.66 kg), hot carcass yield (45.60%) and cold carcass yield (45.07%) exhibited the no response to treatment. In addition to these variables, the diets also did not influence subcutaneous fat thickness (2.54 mm), longissimus muscle area (13.34 cm2), morphometric measurements of the carcass, or the proportions of muscle and fat. Therefore, legume hays associated with spineless cactus can be used to feed ½ Santa Inês × ½ Soinga lambs in the feedlot, as this strategy provides heavy animals at the time of slaughter and carcasses with desirable degrees of muscularity and adiposity.
Topics: Adiposity; Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Cactaceae; Diet; Fabaceae; Male; Paraspinal Muscles; Sheep; Weight Gain
PubMed: 34919579
DOI: 10.1371/journal.pone.0261554 -
Heliyon Dec 2023Chinese Martial arts is becoming increasingly prevalent worldwide. There is insufficient evidence to prove the health effects of martial arts due to methodological...
PURPOSE
Chinese Martial arts is becoming increasingly prevalent worldwide. There is insufficient evidence to prove the health effects of martial arts due to methodological weaknesses. The aim of this study was to better understand the effects of Chinese martial arts on the skeletal and muscular status of the lumbar spine by quantitative magnetic resonance imaging (MRI).
METHODS
Nine elite martial arts athletes, eighteen amateurs, and eighteen sedentary volunteers underwent T2 mapping and q-Dixon imaging of the lumbar spine on a 3T (Tesla) system. T2 (Transverse) relaxation times were measured in different regions of interest of the intervertebral disc (IVD). Fat Fraction (FF) was measured in the paraspinal muscles and vertebral body.
RESULTS
Compared to the sedentary controls, martial arts athletes showed: (1) increased T2 times in the nucleus pulposus, especially in the central nucleus pulposus ( = 0.004); (2) decreased FF in the multifidus and erector spinae (all < 0.04), and increased cross-sectional area in the psoas, quadratus lumborum, and multifidus (all < 0.03); (3) decreased FF in vertebral body ( = 0.001). There was no significant difference in all quantitative MRI parameters between athletes and amateur enthusiasts. Besides, paraspinal muscle FF was negatively correlated with IVD T2 times (ρ = -0.221; = 0.014) and positively correlated with vertebral body FF (ρ = 0.314; < 0.001).
CONCLUSIONS
Chinese martial arts has a positive effect on lumbar tissues, manifesting as better disc hydration, paraspinal muscle hypertrophy and reduced fat infiltration, and lower vertebral body fat content. Our study suggests a possible mechanism: martial arts practice enhances paraspinal muscles to maintain spinal stability, indirectly contributing to slowing down bone marrow conversion and promoting IVD hydration.
PubMed: 38076039
DOI: 10.1016/j.heliyon.2023.e23090