Relationship Between Lumbar Foraminal Stenosis and Multifidus Muscle Atrophy: A Retrospective Cross-Sectional Study.

IF 2.6 2区医学 Q2 CLINICAL NEUROLOGY

Spine Pub Date : 2025-05-15 Epub Date: 2024-08-01 DOI:10.1097/BRS.0000000000005113

Ali E Guven, Lukas Schönnagel, Erika Chiapparelli, Gaston Camino-Willhuber, Jiaqi Zhu, Thomas Caffard, Artine Arzani, Kyle Finos, Isaac Nathoo, Krizia Amoroso, Jennifer Shue, Andrew A Sama, Frank P Cammisa, Federico P Girardi, Alexander P Hughes

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引用次数: 0

Abstract

Study design: A retrospective cross-sectional study.

Objective: To evaluate the relationship between lumbar foraminal stenosis (LFS) and multifidus muscle atrophy.

Background: The multifidus muscle is an important stabilizer of the lumbar spine. In LFS, the compression of the segmental nerve can give rise to radicular symptoms and back pain. LFS can impede function and induce atrophy of the segmentally innervated multifidus muscle.

Materials and methods: Patients with degenerative lumbar spinal conditions who underwent posterior spinal fusion for degenerative lumbar disease from December 2014 to February 2024 were analyzed. Multifidus fatty infiltration (FI) and functional cross-sectional area (fCSA) were determined at the L4 upper endplate axial level on T2-weighted MRI scans using dedicated software. The severity of LFS was assessed at all lumbar levels and sides using the Lee classification (grade: 0-3). For each level, Pfirrmann and Weishaupt gradings were used to assess intervertebral disc disease (IVDD) and facet joint osteoarthritis (FJOA), respectively. Multivariable linear mixed models were run for the LFS grade of each level and side separately as the independent predictor of multifidus FI and fCSA. Each analysis was adjusted for age, sex, BMI, as well as FJOA and IVDD of the level corresponding to the LFS.

Results: A total of 216 patients (50.5% female) with a median age of 61.6 years (interquartile range=52.0-69.0) and a median BMI of 28.1 kg/m 2 (interquartile range=24.8-33.0) were included. Linear mixed model analysis revealed that higher multifidus FI [estimate (CI)=1.7% (0.1-3.3), P =0.043] and lower fCSA [-18.6 mm 2 (-34.3 to -2.6), P =0.022] were both significantly predicted by L2-L3 level LFS severity.

Conclusion: The observed positive correlation between upper segment LFS and multifidus muscle atrophy points toward compromised innervation. This necessitates further research to establish the causal relationship and guide prevention efforts.

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腰椎管狭窄与多裂肌萎缩的关系--一项回顾性横断面研究

研究设计回顾性横断面研究：评估腰椎管狭窄症（LFS）与多裂肌萎缩之间的关系：背景：多裂肌是腰椎的重要稳定器。背景：多裂肌是腰椎的重要稳定器，在腰椎管狭窄症中，节段神经受压可引起根性症状和背痛。腰椎退行性变会阻碍节段支配的多裂肌的功能并诱发其萎缩：方法：对2014年12月至2024年2月期间因退行性腰椎病接受后路脊柱融合术的退行性腰椎病患者进行分析。使用专用软件在T2加权磁共振成像扫描中测定L4上终板轴向水平的多裂肌脂肪浸润（FI）和功能横截面积（fCSA）。采用李氏分类法（等级：0 - 3）评估所有腰椎级别和两侧的 LFS 严重程度。对于每个水平，分别使用 Pfirrmann 和 Weishaupt 分级来评估椎间盘疾病（IVDD）和面关节骨关节炎（FJOA）。多变量线性混合模型将每个水平和每侧的 LFS 分级分别作为多裂肌 FI 和 fCSA 的独立预测因子。每项分析都对年龄、性别、体重指数、FJOA和LFS对应水平的IVDD进行了调整：共纳入 216 名患者（50.5% 为女性），中位年龄为 61.6 岁（IQR=52.0 - 69.0），中位体重指数为 28.1 kg/m2（IQR=24.8 - 33.0）。线性混合模型分析显示，L2-L3水平LFS严重程度可显著预测较高的多裂肌FI（估计值[置信区间]=1.7% [0.1 - 3.3]，P=0.043）和较低的fCSA（-18.6 mm2 [-34.3 - -2.6]，P=0.022）：结论：观察到的上段 LFS 与多裂肌萎缩之间的正相关性表明神经支配受到了损害。结论：观察到的上段 LFS 与多裂肌萎缩之间的正相关性表明神经支配受到了损害，因此有必要开展进一步研究，以确定两者之间的因果关系并指导预防工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine 医学-临床神经学

CiteScore

5.90

自引率

6.70%

发文量

361

审稿时长

6.0 months

期刊介绍： Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.