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Year :2022
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Month :
July
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Volume :
11
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Issue :
3
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Page :
RO40 - RO44
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Lumbar Multifidus Muscle Fatty Atrophy and Lumbar Disc Degeneration: Are they Associated in Middle Aged Patients with Low Backache?
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Correspondence Address :
SC Sanjay, V Ram Sanjith, Harshavardan, Vikyath Satish,
Dr. V Ram Sanjith,
Room No. 202, Kempegowda Institute of Medical Sciences, Residents Hostel, VV
Puram, Bengaluru, Karnataka, India.
E-mail: rramsanjith@gmail.com
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Introduction: Introduction: Low backache being one of the most common problems faced in the society mainly due to sedentary lifestyle and reduced physical activity which inturn leads to overweight, obesity and atrophy of paraspinal muscles. Disc prolapse is one of the most common causes of low backache. Hence, knowing the aetiological factors and treatment of the same at an early stage is beneficial.
Aim: To determine the association between the grades of lumbar disc degeneration with degree of fatty infiltration of lumbar multifidus muscle in middle aged patients with low backache using Magnetic Resonance Imaging (MRI).
Materials and Methods: A prospective observational study was conducted from April 2020 to February 2021 in Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India, with a study population of 201 middle aged patients who complaints of low back pain for more than three months. All patients who met the inclusion and exclusion criteria underwent plain MRI for Lumbosacral (LS) spine with 16 channel 1.5 tesla strength MR machine. Lumbar intervertebral disc degeneration was graded according to the Pfirrmann classification using T2 sequence in the sagittal plane. For the evaluation of the degree of fatty infiltration of lumbar multifidus muscle, axial T2-weighted slices were used to detect the cross-sectional area of the right and left lumbar multifidus muscle involvement. Chi-square test was used to find the association between varying grades of disc degeneration and severity of fat infiltration at Lumbar (L)4-L5 and L5-Sacral (S) 1 regions.
Results: There was significant association between the grade of lumbar disc degeneration and the degree of atrophy of multifidus muscle with p-value <0.001 in middle aged patients with low backache. There was significant relation with fatty muscle infiltration with a p-value of <0.001 in L4-L5 and 0.03 in L5-S1 disc spaces. Most of the patients had grade III intervertebral disc degeneration in both L4/L5 and L5/S1.
Conclusion: Lumbar multifidus muscle atrophy is common in grade 3 Pfirrmann classification of lumbar disc degeneration at both L4/L5 and L5/S1 levels.
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