TITLE:
Impact of Multifidus Muscle Morphometry on the Clinical Evolution of Chronic Low Back Pain
AUTHORS:
Ndèye Bigué Mar, Aïnina Ndiaye, Abdoulaye Ndoye Diop, Gor Side Diagne, Babacar Diao, Souleymane Diao, Racky Wade, Issa Dior Seck, Karim Yacouba Garba, Sokhna Astou Gawane Thiam, Mamadou Ndiaye, Magaye Gaye, Magatte Gaye Sakho, Jean Marc Ndiaga Ndoye, Mamadou Diop, Assane Ndiaye, Abdoulaye Ndiaye
KEYWORDS:
Morphometry, Multifidus, Low Back Pain, Physiotherapy
JOURNAL NAME:
Forensic Medicine and Anatomy Research,
Vol.11 No.1,
January
13,
2023
ABSTRACT: Purpose: The multifidus muscle is an important extensor
muscle of the lumbar spine. It plays a major role in the stability and
realization of axial rotation movements of the thoraco-lumbar spine. Its
atrophy by fatty degeneration would
be at the origin of the occurrence of chronic low back pain which constitutes a
public health problem in Senegal. Taking into account its anatomy is essential
for the etiopathogenic analysis and the treatment of low back pain. The purpose
of our work was to investigate the impact of multifidus muscle morphometry on
the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to
May 2022. It involved 100 patients seen in the neurology department of Fann
Hospital for chronic low back pain and who had already had a scanner falling within
the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software
to model and analyze the morphometric data of the multifidus muscle after
physiotherapy and control lumbar scans. Results: The sex ratio was 2.23.
The average age of the patients was 45 ± 7 years. On the initial CT scan,
according to the Hadar classification, we noted a predominance of grade 2 with
56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the
majority of patients, 67%, had grade 1. A conflicting circumferential disc
bulge with the roots predominating in L5/S1 was present in 94% of men (p-value
= 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm3 ± 39, after physiotherapy it was 203 mm3 ± 42 with a progression
rate of 5.2%. Clinically, severe type pain had regressed from 86% before
physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion:
Taking into account the morphometry of the multifidus is an essential element
in the management of chronic low back pain.