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Selective changes in multifidus dimensions in patients with chronic low back pain

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Résumé

Cette étude a été réalisée chez cinquante deux patients (27 hommes, 25 femmes), présentant une lombalgie soit récente (depuis moins de 18 mois), soit chronique (depuis plus de 18 mois) associée à une radiculalgie unilatérale. Le but de la recherche était de déterminer si l'atrophie des muscles paravertébraux était globale ou élective. Lors de l'examen scannographique de routine pratiqué chez ces patients, une coupe transversale a été pratiquée le long du plateau supérieur de la 4e vertèbre lombaire, permettant d'évaluer l'étendue de la surface occupée par ces muscles paravertébraux et leurs composants, plus particulièrement le muscle multifide et le muscle érecteur du rachis. Les résultats indiquent des modifications électives du muscle multifide chez les patients porteurs de lombalgies, et réflètent vraisemblablement une réponse adaptative de ce muscle qui semble jouer un rôle accru dans la stabilisation du rachis lombaire face à l'atrophie globale des muscles paravertébraux.

Summary

This study of 52 patients (27 men) with recent (18 months) or chronic (>18 months) low back and unilateral radicular pain symptoms was undertaken to investigate whether wasting of the paraspinal muscle components is generalised or selective. During the patients' routine computed tomographic lumbar spinal scans a standardised transaxial view was obtained along the upper end-plate of the L4 vertebra, and the cross-sectional areas of the paraspinal muscles and their components, multifidus and erector spinae, estimated. Irrespective of whether the symptoms were recent or chronic, multifidus dimensions were significantly greater on the side ipsilateral to the radicular pain symptoms. The results indicate selective changes of multifidus in these patients and possibly reflect an adaptive response by this muscle, such as to an increased role in stabilising the lumbar spine in the face of overall paraspinal muscle atrophy.

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Author notes

  1. M. J. Stokes (Visiting Research Associate)

    Present address: Department of Physiotherapy, University of Queensland, Australia

Authors and Affiliations

  1. Rheumatic Diseases Centre, University of Manchester, UK

    M. J. Stokes (Visiting Research Associate), R. G. Cooper & M. I. V. Jayson

  2. Department of Radiology, Hope Hospital, M6 8HD, Salford, UK

    G. Morris

Authors
  1. M. J. Stokes
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  2. R. G. Cooper
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  3. G. Morris
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  4. M. I. V. Jayson
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Additional information

Present address: Royal Hospital and Home, Putney, West Hill, London SW15 3SW, UK

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Stokes, M.J., Cooper, R.G., Morris, G. et al. Selective changes in multifidus dimensions in patients with chronic low back pain. Eur Spine J 1, 38–42 (1992). https://doi.org/10.1007/BF00302141

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