Multifidus muscle fatty infiltration as an index of dysfunction in patients with single-segment degenerative lumbar spinal stenosis: A case-control study based on propensity score matching. (May 2020)

• Record Type: Journal Article
• Authors: Liu, Yang; Liu, Yuzeng; Hai, Yong; Liu, Tie; Guan, Li; Chen, Xiaolong; Wang, Yunsheng
• Is Part Of: Journal of clinical neuroscience. Volume 75(2020)
• Page Start: 139
• Page End: 148
• Publication Date: 2020-05
• Subjects: AUC The area under the ROC curve -- BMI Body mass index -- CSA Cross-sectional areas -- CSAF Cross-sectional areas of fatty free -- CI Confidence interval -- DLSS Degenerative lumbar spinal stenosis -- FIR Fatty infiltration rate -- MRI Magnetic resonance imaging -- ODI Oswestry Disability Index -- OR Odds ratio -- ROC Receiver operating characteristic curve -- SF-36 BP Bodily pain of Physical component summary score of the Medical Outcomes Study 36-item Short-Form Health Survey -- VB Vertebral body; Degenerative lumbar spinal stenosis -- Multifidus muscle -- Fatty infiltration -- Magnetic resonance image -- Dysfunction; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.03.001
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Multifidus muscle was studied quantitatively in patients with L4-5 segment stenosis. The controls without spinal disorders were matched to the patients with stenosis. Intramuscular fat at L5-S1 were greater in patients with stenosis than the controls. Significant fatty infiltration may be correlated with the patient's poor function. Propensity score matching and confounder adjusting were the strengths of the study. Abstract: The multifidus muscle morphology and its relation to the function of patients with degenerative lumbar spinal stenosis (DLSS) remains unclear. This study aimed to investigate the multifidus muscle morphology in patients with DLSS and to determine its relations to the patients function. Sixty-two patients with single-segment DLSS at L4-5 and sixty control patients with non-spinal-derived low back pain were retrospectively enrolled and further matched based on propensity scores. The Oswestry Disability Index (ODI) and bodily pain using the Short-Form Health Survey were evaluated. The cross-sectional area (CSA), CSA of fatty free (CSAF), and fatty infiltration rate [FIR; i.e., (1- CSAF/CSA) × 100%] of the multifidus muscle were measured on magnetic resonance images using ImageJ software. Adjustment for confounders was performed using generalized linear models. The FIR at L5-S1 in controls was statistically significant but slightly less than the DLSS group. The between-groups difference was 5% (p < 0.001), and 2.8% (p = 0.036) in the complete and matching cohorts, respectively, after adjustment. Statistically significant differences were not observed in other multifidus muscle parameters between the groups. FIR > 20% at L5-S1 was independently associated with ODI ≥ 41 in patients with DLSS [Retaining demography as control block or not, Odds ratio (OR) = 8.4, p = 0.023; OR = 12.3, p = 0.030]. The multifidus muscle at L5-S1 demonstrated slightly greater fatty infiltration in patients with L4-5 single-segment DLSS than controls. Significant fatty infiltration in the multifidus muscle at L5-S1 may be correlated with poor function in patients with L4-5 single-segment DLSS.