Spine Community News: The spine is surrounded by muscles anteriorly (psoas) and posteriorly (multifidus). These muscular structures are essential for motion and stability of the spine. Ideal function of these muscles requires strength and flexibility. If these structures became weak, stamina can be affected resulting in pain and advanced degeneration of non-muscular structure like discs and joints.
Atrophy of paraspinous muscle is seen in patients with back pain, lumbar radiculopathy and degenerative lumbar kyphosis. Increased fatty infiltration is correlated with lumbar radiculopathy and degenerative lumbar kyphosis.
A review of 21 studies of paraspinous muscles correlated the level of muscle atrophy and fat with a variety of spine conditions. Measurements of muscle cross-sectional areas were obtained by ultrasound or magnetic resonance imaging. In normal volunteers, men have more cross-sectional area than women. Similarly, fatty infiltration increases with aging with a higher proportion in women than men. In regard to muscle atrophy, the painful side is smaller compared to the non-painful side. Fatty infiltration was also noted more often on the painful side. The longer the painful period, greater was the extent of fat infiltration. Fatty infiltration was correlated with self-reported disability and decreased lumbar flexion. Fatty infiltration was less with individuals with recurrent or non-continuous chronic low back pain.
The important issue is whether muscle changes are the cause or the result of spinal disorders. What this review shows is that muscle changes occur. More attention should be paid to the status of spinal muscles. Maintaining ideal muscle integrity is important for painless, spine function.
Park MS et al. Paraspinal muscles of patients with lumbar diseases. J Neurol Surg A Cent Eur Neurosurg 2018 Apr 16 doi 10.1055/s-0038-163933
David Borenstein, MD
Executive Editor TheSpineCommunity.com