Skip to main content
Erschienen in: European Spine Journal 9/2013

01.09.2013 | Original Article

MRI features of the psoas major muscle in patients with low back pain

verfasst von: Juraj Arbanas, Ivan Pavlovic, Verner Marijancic, Hrvoje Vlahovic, Gordana Starcevic-Klasan, Stanislav Peharec, Snjezana Bajek, Damir Miletic, Daniela Malnar

Erschienen in: European Spine Journal | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose was to investigate the changes of the psoas major muscles (PM) cross-sectional area (CSA) and fat infiltration in the PM and to investigate the association between the morphology of the PM and expression of the degenerative changes of lumbar spine in patients with low back pain (LBP).

Methods

T2-weighted scans for measurements of the CSA and analysis of fat infiltration were performed on 42 patients and 49 controls using a 1.5 Tesla MR system. For a quantitative analysis of fat tissue infiltration a 4-grade visual scale was used.

Results

Patients had bigger CSA of the PM than controls at the levels of L3/L4 and L4/L5 intervertebral disc (P < 0.05). Patients with apparent degenerative changes of the lumbar spine had smaller CSA of the PM compared to the patients without apparent changes at the levels of L3/L4 and L4/L5 (P < 0.05). At the levels of L4/L5 and L5/S1 patients with present Modic changes in the lumbar vertebral bodies showed smaller CSA of the PM compared to the patients without Modic changes (P < 0.05). However, CSA of the PM in the patients with degenerative changes of lumbar spine and Modic changes was still bigger than the one of the controls. At all analyzed levels correlation between CSAs of the PM and fat infiltration of the lumbar paraspinal muscles was negative.

Conclusion

Results suggest increased activity of the PM in LBP patients but PM also remains active regardless of the presence of degenerative and Modic changes of the lumbar spine.
Literatur
1.
Zurück zum Zitat Urban JP, Roberts S (2003) Degeneration of the intervertebral disc. Arthr Res Ther 5:120–130CrossRef Urban JP, Roberts S (2003) Degeneration of the intervertebral disc. Arthr Res Ther 5:120–130CrossRef
2.
Zurück zum Zitat Mengiardi B, Schmid MR, Boos N, Pfirrmann CW, Brunner F, Elfering A, Hodler J (2006) Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. Radiology 240:786–792PubMedCrossRef Mengiardi B, Schmid MR, Boos N, Pfirrmann CW, Brunner F, Elfering A, Hodler J (2006) Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. Radiology 240:786–792PubMedCrossRef
3.
Zurück zum Zitat Kader DF, Wardlaw D, Smith FW (2000) Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol 55:145–149PubMedCrossRef Kader DF, Wardlaw D, Smith FW (2000) Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol 55:145–149PubMedCrossRef
4.
Zurück zum Zitat Standring S (2005) Gray’s anatomy, 39th edn. The anatomical basis of clinical practice. Elsevier, Curchill Livingstone, Edinburgh, pp 1444–1446 Standring S (2005) Gray’s anatomy, 39th edn. The anatomical basis of clinical practice. Elsevier, Curchill Livingstone, Edinburgh, pp 1444–1446
5.
Zurück zum Zitat Penning L (2002) Spine stabilization by psoas muscle during walking and running. Eur Spine J 11:89–90PubMedCrossRef Penning L (2002) Spine stabilization by psoas muscle during walking and running. Eur Spine J 11:89–90PubMedCrossRef
6.
Zurück zum Zitat Penning L (2000) Psoas muscle and lumbar spine stability: a concept uniting existing controversies. Eur Spine J 9:577–585PubMedCrossRef Penning L (2000) Psoas muscle and lumbar spine stability: a concept uniting existing controversies. Eur Spine J 9:577–585PubMedCrossRef
7.
Zurück zum Zitat Bogduk N, Pearcy M, Hadfield G (1992) Anatomy and biomechanics of psoas major. Clin Biomech 7:109–119CrossRef Bogduk N, Pearcy M, Hadfield G (1992) Anatomy and biomechanics of psoas major. Clin Biomech 7:109–119CrossRef
8.
Zurück zum Zitat Dangaria TR, Naesh O (1998) Changes in cross-sectional area of psoas major muscle in unilateral sciatica caused by disc herniation. Spine 23:928–931PubMedCrossRef Dangaria TR, Naesh O (1998) Changes in cross-sectional area of psoas major muscle in unilateral sciatica caused by disc herniation. Spine 23:928–931PubMedCrossRef
9.
Zurück zum Zitat Barker KL, Shamley DR, Jackson D (2004) Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine 29:E515–E519PubMedCrossRef Barker KL, Shamley DR, Jackson D (2004) Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine 29:E515–E519PubMedCrossRef
10.
Zurück zum Zitat Ploumis A, Michailidis N, Christodoulou P, Kalaitzoglou I, Gouvas G, Beris A (2011) Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease. Br J Radiol 84:709–713PubMedCrossRef Ploumis A, Michailidis N, Christodoulou P, Kalaitzoglou I, Gouvas G, Beris A (2011) Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease. Br J Radiol 84:709–713PubMedCrossRef
11.
Zurück zum Zitat Parkkola R, Rytökoski U, Kormano M (1993) Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects. Spine 18:830–836PubMedCrossRef Parkkola R, Rytökoski U, Kormano M (1993) Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects. Spine 18:830–836PubMedCrossRef
12.
Zurück zum Zitat Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, De Cuyper HJ (2000) CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 9:266–272PubMedCrossRef Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, De Cuyper HJ (2000) CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 9:266–272PubMedCrossRef
13.
Zurück zum Zitat Ropponen A, Videman T, Battié MC (2008) The reliability of paraspinal muscles composition measurements using routine spine MRI and their association with back function. Man Ther 13:349–356PubMedCrossRef Ropponen A, Videman T, Battié MC (2008) The reliability of paraspinal muscles composition measurements using routine spine MRI and their association with back function. Man Ther 13:349–356PubMedCrossRef
14.
Zurück zum Zitat Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf-Yde C (2007) Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? BMC Med 5:2PubMedCrossRef Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf-Yde C (2007) Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? BMC Med 5:2PubMedCrossRef
15.
Zurück zum Zitat Videman T, Battié MC, Gill K, Manninen H, Gibbons LE, Fisher LD (1995) Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration. Spine 20:928–935PubMedCrossRef Videman T, Battié MC, Gill K, Manninen H, Gibbons LE, Fisher LD (1995) Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration. Spine 20:928–935PubMedCrossRef
16.
Zurück zum Zitat Hansen L, de Zee M, Rasmussen J, Andersen TB, Wong C, Simonsen EB (2006) Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling. Spine 31:1888–1899PubMedCrossRef Hansen L, de Zee M, Rasmussen J, Andersen TB, Wong C, Simonsen EB (2006) Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling. Spine 31:1888–1899PubMedCrossRef
17.
Zurück zum Zitat Zhao F, Pollintine P, Hole BD, Dolan P, Adams MA (2005) Discogenic origins of spinal instability. Spine 30:2621–2630PubMedCrossRef Zhao F, Pollintine P, Hole BD, Dolan P, Adams MA (2005) Discogenic origins of spinal instability. Spine 30:2621–2630PubMedCrossRef
18.
Zurück zum Zitat Ranson CA, Burnett AF, Kerslake R, Batt ME, O’Sullivan PB (2006) An investigation into the use of MR imaging to determine the functional cross-sectional area of lumbar paraspinal muscles. Eur Spine J 15:764–773PubMedCrossRef Ranson CA, Burnett AF, Kerslake R, Batt ME, O’Sullivan PB (2006) An investigation into the use of MR imaging to determine the functional cross-sectional area of lumbar paraspinal muscles. Eur Spine J 15:764–773PubMedCrossRef
19.
Zurück zum Zitat Hides J, Gilmore C, Stanton W, Bohlscheid E (2008) Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther 13:43–49PubMedCrossRef Hides J, Gilmore C, Stanton W, Bohlscheid E (2008) Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther 13:43–49PubMedCrossRef
21.
Zurück zum Zitat Rahme R, Moussa R (2008) The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR Am J Neuroradiol 29:838–842PubMedCrossRef Rahme R, Moussa R (2008) The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR Am J Neuroradiol 29:838–842PubMedCrossRef
22.
Zurück zum Zitat Albert HB, Manniche C (2007) Modic changes following lumbar disc herniation. Eur Spine J 16:977–982PubMedCrossRef Albert HB, Manniche C (2007) Modic changes following lumbar disc herniation. Eur Spine J 16:977–982PubMedCrossRef
23.
Zurück zum Zitat Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30:1173–1180PubMedCrossRef Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30:1173–1180PubMedCrossRef
24.
Zurück zum Zitat Crombez G, Vervaet L, Lysens R, Baeyens F, Eelen P (1998) Avoidance and confrontation of painful, back-straining movements in chronic back pain patients. Behav Modif 22:62–77PubMedCrossRef Crombez G, Vervaet L, Lysens R, Baeyens F, Eelen P (1998) Avoidance and confrontation of painful, back-straining movements in chronic back pain patients. Behav Modif 22:62–77PubMedCrossRef
25.
Zurück zum Zitat Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878PubMedCrossRef Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878PubMedCrossRef
Metadaten
Titel
MRI features of the psoas major muscle in patients with low back pain
verfasst von
Juraj Arbanas
Ivan Pavlovic
Verner Marijancic
Hrvoje Vlahovic
Gordana Starcevic-Klasan
Stanislav Peharec
Snjezana Bajek
Damir Miletic
Daniela Malnar
Publikationsdatum
01.09.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 9/2013
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-2749-x

Weitere Artikel der Ausgabe 9/2013

European Spine Journal 9/2013 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.