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.
Keywords
paraspinal muscles - lumbar spine - radiculopathy - degenerative lumbar kyphosis
