Correlation between Lumbar Multifidus Muscle Degeneration and Low Back Pain in Degenerative Lum -bar Spondylolisthesis Patients

Abstract：Objective To analysis the correlation between lumbar multifidus muscle degeneration and Visual Ana-logue Score(VAS) ,Oswestry disability index(ODI) in degenerative lumbar spondylolisthesis patients .Methods A total of 64 patients(24 males ,40 females) with a mean age of (63 .02 ± 10 .59) years(range ,45 ～ 84 years) was included in this retrospective study .The mean cross-sectional area of lumbar multifidus muscle on both sides and the cross-sectional area of the fifth lumbar vertebra were measured on the MRI imaging and then the ratio was calculated .The severity of the fatty infiltration was also evaluated by MRI and 4 different degrees(grade 0 ,1 ,2 ,3)were determined .Patients were divided into two groups :group A(grade 0 or 1) and group B(grade 1 or 2) .The VAS and ODI were cornpared between two groups .The correlations between the atrophy ,fatty infiltration of multifidus muscle and VAS ,ODI were analyzed . Results The mean ratio of multifidus muscle atrophy of all 64 cases was (0 .78 ± 0 .05) .The fatty infiltration of grade 0 ,1 ,2 and 3 in multifidus muscle were observed in 6 ,11 ,20 and 27 patients respectively .The mean VAS and ODI of all patients was (5 .3 ± 1 .4) and (47 .1 ± 13 .5)％ .Patients in group A had significantly lower VAS and ODI than those in group A (P = 0 .016 and 0 .009) .There was negative correlation between the ratio of multifidus muscle atrophy and VAS ,ODI(r = - 0 .43 ,P = 0 .024 ;r = - 0 .49 ,P = 0 .004) .Meanwhile ,positive correlation was observed between the fat-ty infiltration and VAS ,ODI(r = 0 .53 ,P = 0 .019 ;r = 0 .44 ,P = 0 .015) .Conclusion There is a correlation between the severity of lumbar multifidus muscle degeneration and low back pain in patients with degenerative lumbar spondylolis -thesis .The more severe of lumbar multifidus muscle degeneration indicates more severe low back pain and disability .