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The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis
Introduction Lumbar degenerative spondylolisthesis (DS) is one of the most common causes of low back pain. The lumbar muscles, such as the psoas major (PM), erector spinae (ES), and multifidus (MF) muscles, play an important role in the stability and functional movement of the lumbar spine. The quan...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557985/ https://www.ncbi.nlm.nih.gov/pubmed/34733598 http://dx.doi.org/10.7759/cureus.18428 |
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author | Ohyama, Shuhei Aoki, Yasuchika Inoue, Masahiro Nakajima, Takayuki Sato, Yusuke Fukuchi, Hiroyuki Sakai, Takayuki Ochi, Shigehiro Yanagawa, Noriyuki Ohtori, Seiji |
author_facet | Ohyama, Shuhei Aoki, Yasuchika Inoue, Masahiro Nakajima, Takayuki Sato, Yusuke Fukuchi, Hiroyuki Sakai, Takayuki Ochi, Shigehiro Yanagawa, Noriyuki Ohtori, Seiji |
author_sort | Ohyama, Shuhei |
collection | PubMed |
description | Introduction Lumbar degenerative spondylolisthesis (DS) is one of the most common causes of low back pain. The lumbar muscles, such as the psoas major (PM), erector spinae (ES), and multifidus (MF) muscles, play an important role in the stability and functional movement of the lumbar spine. The quantities and qualities of these muscles may be related to the occurrence of DS and lumbopelvic parameters, such as lumbar lordosis (LL) and sacral slope (SS). However,the influence of lumbar muscles on DS and lumbopelvic alignment is not well understood. Methods Patients with L4 DS (DS group, n=25) and without DS (non-DS group, n=25) were included. Using sagittal reconstructed CT images of patients who visited our hospital for reasons other than low back disorders, LL, upper lumbar lordosis ([ULL] L1-L4), lower lumbar lordosis ([LLL] L4-S1), and SS were examined. To evaluate the quantity and quality of lumbar muscles, the gross cross-sectional area (GCSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of the PM, ES, and MF muscles were measured by CT images. The lumbopelvic parameters, FCSA, GCSA, and FI of lumbar muscles were compared between the two groups. Then, each lumbar muscle parameter was analyzed for correlation with DS and lumbopelvic parameters. Results DS patients displayed significantly greater ULL and lower FI of the PM and ES muscles than non-DS patients (p=0.0078, 0.031, and 0.010, respectively). The FI of the ES muscle was significantly correlated with the presence of DS (p=0.010). The FCSA of the ES and MF muscles and the GCSA of the MF muscle showed a significant correlation with LL and SS in the non-DS group (p<0.05), but not in the DS group.. Conclusion ULL was greater in L4 DS patients, possibly related to the better quality of the ES muscle. All DS patients showed mild (grade I) spondylolisthesis, suggesting the possibility that lumbar muscle quality is better in patients with mild DS than in those without DS. The ES and MF muscles may play an important role in maintaining the lumbar lordotic angle in non-DS patients but not in DS patients. |
format | Online Article Text |
id | pubmed-8557985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-85579852021-11-02 The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis Ohyama, Shuhei Aoki, Yasuchika Inoue, Masahiro Nakajima, Takayuki Sato, Yusuke Fukuchi, Hiroyuki Sakai, Takayuki Ochi, Shigehiro Yanagawa, Noriyuki Ohtori, Seiji Cureus Orthopedics Introduction Lumbar degenerative spondylolisthesis (DS) is one of the most common causes of low back pain. The lumbar muscles, such as the psoas major (PM), erector spinae (ES), and multifidus (MF) muscles, play an important role in the stability and functional movement of the lumbar spine. The quantities and qualities of these muscles may be related to the occurrence of DS and lumbopelvic parameters, such as lumbar lordosis (LL) and sacral slope (SS). However,the influence of lumbar muscles on DS and lumbopelvic alignment is not well understood. Methods Patients with L4 DS (DS group, n=25) and without DS (non-DS group, n=25) were included. Using sagittal reconstructed CT images of patients who visited our hospital for reasons other than low back disorders, LL, upper lumbar lordosis ([ULL] L1-L4), lower lumbar lordosis ([LLL] L4-S1), and SS were examined. To evaluate the quantity and quality of lumbar muscles, the gross cross-sectional area (GCSA), functional cross-sectional area (FCSA), and fat infiltration (FI) of the PM, ES, and MF muscles were measured by CT images. The lumbopelvic parameters, FCSA, GCSA, and FI of lumbar muscles were compared between the two groups. Then, each lumbar muscle parameter was analyzed for correlation with DS and lumbopelvic parameters. Results DS patients displayed significantly greater ULL and lower FI of the PM and ES muscles than non-DS patients (p=0.0078, 0.031, and 0.010, respectively). The FI of the ES muscle was significantly correlated with the presence of DS (p=0.010). The FCSA of the ES and MF muscles and the GCSA of the MF muscle showed a significant correlation with LL and SS in the non-DS group (p<0.05), but not in the DS group.. Conclusion ULL was greater in L4 DS patients, possibly related to the better quality of the ES muscle. All DS patients showed mild (grade I) spondylolisthesis, suggesting the possibility that lumbar muscle quality is better in patients with mild DS than in those without DS. The ES and MF muscles may play an important role in maintaining the lumbar lordotic angle in non-DS patients but not in DS patients. Cureus 2021-10-01 /pmc/articles/PMC8557985/ /pubmed/34733598 http://dx.doi.org/10.7759/cureus.18428 Text en Copyright © 2021, Ohyama et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Orthopedics Ohyama, Shuhei Aoki, Yasuchika Inoue, Masahiro Nakajima, Takayuki Sato, Yusuke Fukuchi, Hiroyuki Sakai, Takayuki Ochi, Shigehiro Yanagawa, Noriyuki Ohtori, Seiji The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis |
title | The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis |
title_full | The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis |
title_fullStr | The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis |
title_full_unstemmed | The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis |
title_short | The Quantity and Quality of Lumbar Muscles and Lumbopelvic Parameters in Patients With Degenerative Spondylolisthesis |
title_sort | quantity and quality of lumbar muscles and lumbopelvic parameters in patients with degenerative spondylolisthesis |
topic | Orthopedics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557985/ https://www.ncbi.nlm.nih.gov/pubmed/34733598 http://dx.doi.org/10.7759/cureus.18428 |
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