J Neurol Surg A Cent Eur Neurosurg 2018; 79(04): 323-329
DOI: 10.1055/s-0038-1639332
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Paraspinal Muscles of Patients with Lumbar Diseases

Moon Soo Park
1  Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Korea (the Republic of)
,
Seong-Hwan Moon
2  Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
,
Tae-Hwan Kim
1  Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Korea (the Republic of)
,
JaeKeun Oh
3  Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea, Republic of
,
Seon-Jong Lee
1  Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Korea (the Republic of)
,
Ho Guen Chang
1  Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Korea (the Republic of)
,
Jae-Hyuk Shin
4  Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea (the Republic of)
› Author Affiliations
Further Information

Publication History

30 July 2017

09 November 2017

Publication Date:
16 April 2018 (online)

Abstract

Objective The treatment of atrophy or increased fat infiltration of the lumbar paraspinal muscles of patients with back pain, lumbar radiculopathy, or lumbar degenerative kyphosis is controversial. We review the literature on changes in the lumbar paraspinal muscles of these patients.

Methods We searched Medline for relevant English-language articles and retrieved 25 articles published from 1993 to 2017 on changes in the lumbar paraspinal muscles; 21 met our study criteria. We categorized each article into three groups: randomized clinical trial, nonrandomized prospective study, or retrospective study.

Results We found 1 randomized prospective, 3 nonrandomized prospective, and 17 retrospective studies. Atrophies of the multifidus muscle are found at the level of the L5 vertebral body in patients with back pain, lumbar radiculopathy, and lumbar degenerative kyphosis. Increased fat infiltration to the multifidus muscle was found in the patients with lumbar radiculopathy or lumbar degenerative kyphosis. However, there are controversies over fat infiltration to the multifidus muscle in the patients with back pain and the efficiency of a paramedian surgical approach to prevent the atrophy of the multifidus muscle.

Conclusions Atrophy of the multifidus muscle was found in patients with back pain, lumbar radiculopathy, and lumbar degenerative kyphosis. There was increased fat infiltration to the multifidus muscle in those patients with lumbar radiculopathy or lumbar degenerative kyphosis.