The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation

PurposeThis study aimed to investigate the effect of lumbar multifidus muscle (MF) degeneration on upper lumbar disc herniation (ULDH).MethodsThis study used 3.0T magnetic resonance imaging (MRI) T2 axial weighted images to retrospectively analyze 93 ULDH patients and 111 healthy participants. Sixty...

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Main Authors: Bingwen Wang, Lifei Xu, Peng Teng, Lin Nie, Hongwei Yue
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2024.1323939/full
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author Bingwen Wang
Lifei Xu
Peng Teng
Lin Nie
Lin Nie
Hongwei Yue
author_facet Bingwen Wang
Lifei Xu
Peng Teng
Lin Nie
Lin Nie
Hongwei Yue
author_sort Bingwen Wang
collection DOAJ
description PurposeThis study aimed to investigate the effect of lumbar multifidus muscle (MF) degeneration on upper lumbar disc herniation (ULDH).MethodsThis study used 3.0T magnetic resonance imaging (MRI) T2 axial weighted images to retrospectively analyze 93 ULDH patients and 111 healthy participants. Sixty-five pairs of participants were included in this study using propensity score matching (PSM). Cross-sectional area, fat infiltration area, anteroposterior diameter (APD), lateral diameter (LD), cross-sectional area of the bilateral multifidus muscles at the corresponding level, intervertebral disc area at the corresponding section, and visual analog scale (VAS) score for low back pain (LBP). For inter-group comparisons, we used the t-test, analysis of variance (ANOVA), Mann–Whitney U test, Kruskal–Wallis test, chi-square test, or Fisher's exact test, according to the type of data. We used Pearson correlation analysis to study the correlation between the VAS score and related indicators, and established a predictive model for upper lumbar disc herniation using the receive operative characteristic (ROC) curve analysis method. Finally, univariate and multivariate logistic regression analyses were performed to establish a predictive model for the risk of high lumbar disc herniation.ResultsWe compared the fat areas at the lumbar vertebral levels L1/2, L2/3, and L3/4, as well as the left lateral diameter (LD) (MF), L1/2 left lumbar multifidus muscle index (LMFI), and L1/2 total fat infiltration cross-section area (TFCSA), and found significant differences between the case and control groups (P < 0.001). Furthermore, we observed a significant positive correlation (P < 0.05) between the VAS scores and multiple muscle indicators. Additionally, we developed ROC prediction models to assess the risk of lumbar intervertebral disc protrusion at the L1/2, L2/3, and L3/4 levels, with the results identifying L1/2 TFCSA, L2/3 TFCSA, and L3/4 relative psoas major muscle cross-section area (rPMCSA) as the most predictive indicators. Finally, univariate and multivariate logistic regression analyses showed that the L1/2 rPMCSA, L2/3 TFCSA were significantly associated with the risk of lumbar intervertebral disc protrusion in both models.ConclusionDegeneration of the MF is significantly correlated with the occurrence of ULDH, and the larger the area of fat infiltration in the MF, the more obvious the lower back pain in ULDH patients. In addition, TFCSA can serve as an indicator of the occurrence of ULDH.
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spelling doaj-art-5e12ff165524420e9953010e014728db2025-08-20T02:14:01ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-11-011110.3389/fsurg.2024.13239391323939The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniationBingwen Wang0Lifei Xu1Peng Teng2Lin Nie3Lin Nie4Hongwei Yue5Department of Orthopedics, National Regional Medical Center, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, ChinaDepartment of Clinical Laboratory, Lianyungang Maternal and Child Health Hospital, Affiliated Hospital of Kangda College of Southern Medical University, Lianyungang, ChinaDepartment of Orthopedics, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, ChinaDepartment of Orthopedics, National Regional Medical Center, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, ChinaDepartment of Orthopedics, National Regional Medical Center, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Orthopedics, National Regional Medical Center, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, ChinaPurposeThis study aimed to investigate the effect of lumbar multifidus muscle (MF) degeneration on upper lumbar disc herniation (ULDH).MethodsThis study used 3.0T magnetic resonance imaging (MRI) T2 axial weighted images to retrospectively analyze 93 ULDH patients and 111 healthy participants. Sixty-five pairs of participants were included in this study using propensity score matching (PSM). Cross-sectional area, fat infiltration area, anteroposterior diameter (APD), lateral diameter (LD), cross-sectional area of the bilateral multifidus muscles at the corresponding level, intervertebral disc area at the corresponding section, and visual analog scale (VAS) score for low back pain (LBP). For inter-group comparisons, we used the t-test, analysis of variance (ANOVA), Mann–Whitney U test, Kruskal–Wallis test, chi-square test, or Fisher's exact test, according to the type of data. We used Pearson correlation analysis to study the correlation between the VAS score and related indicators, and established a predictive model for upper lumbar disc herniation using the receive operative characteristic (ROC) curve analysis method. Finally, univariate and multivariate logistic regression analyses were performed to establish a predictive model for the risk of high lumbar disc herniation.ResultsWe compared the fat areas at the lumbar vertebral levels L1/2, L2/3, and L3/4, as well as the left lateral diameter (LD) (MF), L1/2 left lumbar multifidus muscle index (LMFI), and L1/2 total fat infiltration cross-section area (TFCSA), and found significant differences between the case and control groups (P < 0.001). Furthermore, we observed a significant positive correlation (P < 0.05) between the VAS scores and multiple muscle indicators. Additionally, we developed ROC prediction models to assess the risk of lumbar intervertebral disc protrusion at the L1/2, L2/3, and L3/4 levels, with the results identifying L1/2 TFCSA, L2/3 TFCSA, and L3/4 relative psoas major muscle cross-section area (rPMCSA) as the most predictive indicators. Finally, univariate and multivariate logistic regression analyses showed that the L1/2 rPMCSA, L2/3 TFCSA were significantly associated with the risk of lumbar intervertebral disc protrusion in both models.ConclusionDegeneration of the MF is significantly correlated with the occurrence of ULDH, and the larger the area of fat infiltration in the MF, the more obvious the lower back pain in ULDH patients. In addition, TFCSA can serve as an indicator of the occurrence of ULDH.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1323939/fullupper lumbar disc herniationlumbar multifidus musclelumbar multifidus muscle degenerationfat infiltrationpsoas major muscle
spellingShingle Bingwen Wang
Lifei Xu
Peng Teng
Lin Nie
Lin Nie
Hongwei Yue
The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
Frontiers in Surgery
upper lumbar disc herniation
lumbar multifidus muscle
lumbar multifidus muscle degeneration
fat infiltration
psoas major muscle
title The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
title_full The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
title_fullStr The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
title_full_unstemmed The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
title_short The effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
title_sort effect of lumbar multifidus muscle degeneration on upper lumbar disc herniation
topic upper lumbar disc herniation
lumbar multifidus muscle
lumbar multifidus muscle degeneration
fat infiltration
psoas major muscle
url https://www.frontiersin.org/articles/10.3389/fsurg.2024.1323939/full
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