Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantific
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SCIENTIFIC ARTICLE
Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantification with chemical shift magnetic resonance imaging Bahar Yanik & Bahri Keyik & Isik Conkbayir
Received: 17 August 2012 / Revised: 2 October 2012 / Accepted: 4 November 2012 / Published online: 20 December 2012 # ISS 2012
Abstract Objective To evaluate and compare the fatty degeneration of multifidus muscles by chemical shift magnetic resonance imaging (MRI) in patients with chronic low back pain and in asymptomatic volunteers. Materials and methods Sixty-five patients with lumbar disc pathology were selected prospectively for this study. The control group consisted of 25 asymptomatic volunteers. The patients were grouped according to the fatty degeneration of multifidus muscles by a semiquantitative method (grade 0– 4) on axial T2 weighted imaging. Chemical shift MRI was performed in the axial plane using a double-echo fast lowangle shot (FLASH) sequence. Fatty degeneration was calculated through signal intensity suppression rate (SISR) and signal intensity index (SII). Results The semiquantitative grading of fatty degeneration of the multifidus muscle was 0 in 25 of 65 patients (patient group 0), 1 in 20 patients (patient group 1), 2 in 20 patients (patient group 2). Neither grade 3 nor grade 4 were detected in patient groups. For the control group, patient group 0, patient group 1, and patient group 2, median SISR values were 5.00, −9.00, B. Yanik Department of Radiology, Balikesir University, School of Medicine, Balikesir, Turkey B. Keyik Department of Radiology, SB Balikesir Ataturk Devlet Hastanesi (Balikesir Ataturk Government Hospital), Balikesir, Turkey I. Conkbayir Department of Radiology, SB Dişkapi Yildirim Beyazit Eğitim Ve Araştirma Hastanesi (Dişkapi yildirim Beyazit Research and Training Hospital), TR-06110, Dişkapi, Ankara, Turkey B. Yanik (*) Bahcelievler Mahallesi Teknik lise, CAD. No: 146/7 Merkez, Balikesir, Turkey e-mail: [email protected]
−17.50, and −22.50 %, respectively. SII median values were −4.20 % for the control group, 7.00 % for patient group 0, 12.50 % for patient group 1, and 19.50 % for patient group 2. SISR values in the multifidus muscle calculated for the patient groups were significantly lower than those calculated for the control group. SII values in patients groups were significantly higher than in the control group. Conclusions Chemical shift MRI may be a useful method to quantitatively evaluate the fatty degeneration in multifidus muscle in patients with low back pain. Keywords Lumbar Spine . Multifidus . Muscle . Fatty degeneration . Chemical shift MRI
Introduction Low back pain is an important health problem and is one of the main symptoms in lumbar disc pathology. The cause of low back pain is poorly understood [1, 2]. In recent years, studies have shown an association between low back pain and paraspinal muscular weakness [3]. The strength of the trunk flexor and extensor muscles by means of a cable tensiometer was measured and g
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