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

Article information

J Korean Acupunct Moxib Soc. 2013;30(4):45-53
Publication date (electronic) : 2013 September 20
doi : https://doi.org/10.13045/acupunct.2013021
Ji Hwan Nam1,, 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 2013 July 19; Revised 2013 July 30; Accepted 2013 July 30.

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.

Keywords: 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

Baseline Characteristics of Participants (n=132)

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

Comparison between Acute and Chronic Low Back Pain Groups

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

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Article information Continued

Copyright © 2013 KAMMS. Korean Acupuncture & Moxibustion Medicine Society.

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.

Fig. 1.

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)
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)
≥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
p-value† 0.060 0.003 0.176 0.025
ΔVNRS‡ Correlation Coefficients −0.036 −0.029 0.012 0.028
p-value 0.679 0.743 0.890 0.747
Age Correlation Coefficients −0.246 −0.161 −0.286 −0.204
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.