Correlation of paraspinal atrophy and denervation in back pain and spinal stenosis relative to asymptomatic controls.

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  • Author(s): Yarjanian JA;Yarjanian JA; Fetzer A; Yamakawa KS; Tong HC; Smuck M; Haig A
  • Source:
    PM & R : the journal of injury, function, and rehabilitation [PM R] 2013 Jan; Vol. 5 (1), pp. 39-44.
  • Publication Type:
    Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: United States NLM ID: 101491319 Publication Model: Print Cited Medium: Internet ISSN: 1934-1563 (Electronic) Linking ISSN: 19341482 NLM ISO Abbreviation: PM R Subsets: MEDLINE
    • Publication Information:
      Publication: 2019- : [Hoboken, NJ] : Wiley
      Original Publication: New York, NY : Elsevier
    • Subject Terms:
      Lumbar Vertebrae*; Low Back Pain/*surgery ; Magnetic Resonance Imaging/*methods ; Muscle Denervation/*methods ; Muscle, Skeletal/*innervation ; Spinal Stenosis/*diagnosis ; Spine/*pathology; Aged ; Aged, 80 and over ; Double-Blind Method ; Female ; Follow-Up Studies ; Humans ; Low Back Pain/diagnosis ; Low Back Pain/etiology ; Male ; Middle Aged ; Prospective Studies ; Spinal Stenosis/complications ; Treatment Outcome
    • Abstract:
      Objective: To determine the relationship among spinal stenosis, back pain, paraspinal muscle denervation, and paraspinal muscle atrophy.
      Design: A prospective masked, double-controlled study.
      Setting: A university hospital and outpatient spine clinic.
      Participants: Ten asymptomatic subjects, 10 subjects with mechanical low back pain, and 15 subjects with symptomatic spinal stenosis; age range, 55-80 years old.
      Interventions: Magnetic resonance imaging measurements of minimum spinal canal diameter, paraspinal muscle cross-sectional area at the level of the L5-S1 disk, and quantified paraspinal electrodiagnostic testing (MiniPM) were performed by examiners blinded to each other's results and to the participants' clinical information.
      Main Outcome Measurements: Paraspinal muscle cross-sectional area and MiniPM scores.
      Results: A paraspinal cross-sectional area decreased significantly from asymptomatic subjects (3872 mm(2)) to subjects with low back pain (3627 mm(2)) and to subjects with spinal stenosis (2985 mm(2)). In the stenosis group, there was a trend toward increased paraspinal denervation in the subjects with severe spinal stenosis, but this was not statistically significant.
      Conclusions: Symptomatic spinal stenosis results in greater paraspinal muscle atrophy than low back pain alone. The extent of paraspinal atrophy was not significantly explained by the extent of denervation, thus, it may be reversible, and the role of paraspinal muscle rehabilitation in patients with spinal stenosis deserves further study.
      (Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)
    • Comments:
      Comment in: PM R. 2013 Aug;5(8):734-5. (PMID: 23953021)
    • Grant Information:
      R01H00592559 United States PHS HHS; R01HD059259 United States HD NICHD NIH HHS; R0IWD059259 United States PHS HHS
    • Publication Date:
      Date Created: 20130122 Date Completed: 20130702 Latest Revision: 20131007
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.pmrj.2012.08.017
    • Accession Number:
      23332908