The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients

Ji Hwan Nam; Chong Hwan Lee; Seul Ji Lee; Kie Won Kim; Min Jung Lee; Jae Yun Jun; Su Jin Lim; Nam Jung Hong; Ju Hyun Song

doi:10.13045/acupunct.2013021

J Acupunct Res > Volume 30(4); 2013 > Article

Nam, Lee, Lee, Kim, Lee, Jun, Lim, Hong, and Song: The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients

Original Article

The Acupuncture 2013; 30(4): 45-53.

Published online: September 20, 2013

DOI: https://doi.org/10.13045/acupunct.2013021

The Findings of Relation between Cross-sectional Area of Lumbar Paraspinal Muscle and Prognosis in Patients of Acute and Chronic Low Back Pain Patients

Ji Hwan Nam^1,^*, Chong Hwan Lee¹, Seul Ji Lee¹, Kie Won Kim¹, Min Jung Lee¹, Jae Yun Jun¹, Su Jin Lim¹, Nam Jung Hong², Ju Hyun Song¹

¹Department of Acupuncture & Moxibustion Medicine, Jaseng Hospital of Oriental Medicine

²Department of Neuropsychiatry, Jaseng Hospital of Oriental Medicine

^*Corresponding author : Department of Acupuncture & Moxibustion Medicine, Jaseng Hospital of Oriental Medicine, 635, Sinsa-dong, Gangnam-gu, Seoul, 135-896, Republic of Korea, Tel : +82-2-3218-2100 E-mail : sweesen@naver.com

Received July 19, 2013 Revised July 30, 2013 Accepted July 30, 2013

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract

Objectives :

The purpose of this study was to evaluate the relationship between cross-sectional areas of the paraspinal and psoas muscles with low back pain.

Methods :

We assessed the cross-sectional area of the psoas and paraspinal muscles at the superior part of L4 level and vertebral body of L4 of 132 patients who were hospitalized with a chief complaint of low back pain at Jaseng Hospital of Korean Medicine from January 2013 to April 2013. After calculating the mean psoas area, we divided the patients into 2 groups by whether the psoas cross section was larger or smaller than the mean, and compared the admission period, verbal numeric rating scale(NRS) of low back pain(LBP), and improvement of verbal NRS of LBP. We also subcategorized the patients into acute and chronic groups according to the duration period, and compared the cross-sectional area of the psoas and paraspinal muscles.

Results :

Although analyses of the verbal NRS of LBP, and improvement of verbal NRS of LBP between groups with larger and smaller psoas cross section areas showed no significant difference, the admission period was significantly shorter in the group with larger psoas cross section areas. There was no significant difference in analyses of cross section areas in the acute and chronic groups. Of the possible prognostic variables, improvement of verbal NRS of LBP showed no correlation, while the admission period displayed a significant correlation. The cross-sectional area of the psoas and paraspinal muscles divided by the area of the vertebral body of L4 had a significant negative correlation with age.

Conclusions :

The cross-sectional area of the psoas and paraspinal muscles were correlated with the admission period in LBP patients, and the cross-sectional area of the surrounding muscles divided by the area of the L4 vertebral body was negatively correlated with age.

Key Words: Low back pain; Psoas muscle; Paraspinal muscle; Cross-sectional area of muscle.

Fig. 1.

Cross-sectional area of psoas and paraspinal muscles at the superior part of L4 level measured on MRI

Table 1.

Baseline Characteristics of Participants (n=132)

Characteristics		n(%)
Proportion of gender	Male	64(48.48)
Proportion of gender	Female	68(51.51)

Proportion of age	21∼30	23(17.42)
	31∼40	38(28.79)
	41∼50	27(20.45)
	51∼60	32(24.24)
	61∼70	12(9.09)

Duration period of present low back pain	<6weeks	63(47.73)
Duration period of present low back pain	≥12weeks	69(52.27)

Admission period	<10 days	30(22.73)
	<20 days	39(29.55)
	<30 days	38((28.79)
	<40 days	16(12.12)
	<50 days	9(6.82)

Table 2.

Comparison between Groups with Psoas Cross Sections Larger and Smaller than the Mean

	<884.90(n=74)	>884.90(n=58)	p-value^*
BMI^†	22.55±2.46^‡	25.11±3.12	0.060
Age	44.94±2.46	40.42±11.08	0.233
Admission period	22.50±13.85	18.31±9.40	0.009
VNRS^§	6.73±1.91	6.48±2.41	0.024
ΔVNRS	3.44±2.12	3.56±2.25	0.512

^†: body mass index.

^‡: mean ± SD.

^§: verbal numerical rating scale.

^*: independent-samples t-test p<0.05.

Table 3.

Comparison between Acute and Chronic Low Back Pain Groups

	Acute(n=63)	Chronic(n=69)	p-value^*
BMI^†	23.56±2.80^‡	23.56±3.20	0.257
Age	40.48±11.44	45.61±12.80	0.087
Admission period	17.90±11.81	23.54±12.44	0.548
VNRS^§	7.00±2.16	6.29±2.04	0.953
ΔVNRS	3.76±2.34	3.23±1.97	0.083
Psoas muscle	898.58±372.09	872.41±337.43	0.863
Paraspinalis muscle	2193.26±480.46	2083.36±524.71	0.625

^*: independent-samples t-test p<0.05.

^†: body Mass Index.

^‡: mean ± SD.

^§: verbal numerical rating scale.

Table 4.

Correlation Analysis Results among Cross-sectional Area of Muscle, Admission Period, Low Back Pain Improvement and Age

		Cross-sectional area
		Psoas	Paraspinal	Psoas/V^*	Paraspinal/V
Admission period	Correlation Coefficients	−0.164	−0.261	−0.118	−0.195
Admission period	p-value^†	0.060	0.003	0.176	0.025
ΔVNRS^‡	Correlation Coefficients	−0.036	−0.029	0.012	0.028
ΔVNRS^‡	p-value	0.679	0.743	0.890	0.747
Age	Correlation Coefficients	−0.246	−0.161	−0.286	−0.204
Age	p-value	0.004	0.066	0.001	0.019

^*: vertebral body of L4.

^†: Pearson's correlation coefficient p<0.05.

^‡: verbal numerical rating scale.

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