Ann Rehabil Med.  2017 Oct;41(5):801-807. 10.5535/arm.2017.41.5.801.

Asymmetric Atrophy of Paraspinal Muscles in Patients With Chronic Unilateral Lumbar Radiculopathy

• Chon J
• Kim HS
• Lee JH
• Yoo SD
• Yun DH
• Kim DH
• Lee SA
• Han YJ
• Lee HS
• Han YR
• Han S
• Kim Y

• KMID: 2440807
• DOI: http://doi.org/10.5535/arm.2017.41.5.801

Abstract

OBJECTIVE
To assess the cross-sectional area (CSA) of the muscles for investigating the occurrence of asymmetry of the paraspinal (multifidus and erector spinae) and psoas muscles and its relation to the chronicity of unilateral lumbar radiculopathy using magnetic resonance imaging (MRI).
METHODS
This retrospective study was conducted between January 2012 to December 2014. Sixty one patients with unilateral L5 radiculopathy were enrolled: 30 patients had a symptom duration less than 3 months (group A) and 31 patients had a symptom duration of 3 months or more (group B). Axial MRI measured the CSA of the paraspinal and psoas muscles at the middle between the lower margin of the upper vertebra and upper margin of the lower vertebra, and obtained the relative CSA (rCSA) which is the ratio of the CSA of muscles to that of the lower margin of L4 vertebra.
RESULTS
There were no differences in the demographics between the two groups. In group B, rCSA of the erector spinae at the L4-5 level, and that of multifidus at the L4-5 and L5-S1 levels, were significantly smaller on the involved side as compared with the uninvolved side. In contrast, no significant muscle asymmetry was observed in group A. The rCSA of the psoas was not affected in either group.
CONCLUSION
The atrophy of the multifidus and erector spinae ipsilateral to the lumbar radiculopathy was observed only in patients suffering from unilateral radiculopathy for 3 months or more.

Keyword

Paraspinal muscles; Muscular atrophy; Magnetic resonance imaging; Radiculopathy

MeSH Terms

Atrophy*
Demography
Humans
Magnetic Resonance Imaging
Muscles
Muscular Atrophy
Paraspinal Muscles*
Psoas Muscles
Radiculopathy*
Retrospective Studies
Spine

Figure

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  Fig. 1 A flowchart of subjects.

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  Fig. 2 The cross-sectional area (CSA) of the paraspinal and psoas muscles in a patient with unilateral radiculopathy. (A) Sagittal T2-weighted image shows axial plane at the middle between lower margin of L4 and upper margin of L5 vertebrae. (B) CSA measurement of paraspinal muscles: PS, poas muscle; ES, erector spinae muscle; MF, multifidus muscle.

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