Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
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The Correlation between Cross-sectional Area of Lumbar Paraspinal Muscles and Walking Ability in the Patients with Lumbar Spinal Stenosis

척추관 협착증 환자의 보행능력과 요추 주변 근육 단면적의 상관관계 연구

  • Kim, Min Chul (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck & Back Hospital) ;
  • Seo, Young Hoon (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck & Back Hospital) ;
  • Lee, Sang Min (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck & Back Hospital) ;
  • Kim, Yu Jong (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck & Back Hospital) ;
  • Hong, Je Rak (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck & Back Hospital) ;
  • Yoo, Do Hyun (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck & Back Hospital) ;
  • Kim, Ji Su (Department of Acupuncture & Moxibustion Medicine, Mokhuri Neck & Back Hospital) ;
  • Kim, Tae Gyu (Department of Acupuncture & Moxibustion Medicine, Mokhuri Neck & Back Hospital) ;
  • Choi, Jae Young (Department of Acupuncture & Moxibustion Medicine, Mokhuri Neck & Back Hospital) ;
  • Kim, Tae-Hun (Korean Medicine Clinical Trial Center, Kyung Hee University Korean Medicine Hospital)
  • 김민철 (모커리한방병원 한방재활의학과) ;
  • 서영훈 (모커리한방병원 한방재활의학과) ;
  • 이상민 (모커리한방병원 한방재활의학과) ;
  • 김유종 (모커리한방병원 한방재활의학과) ;
  • 홍제락 (모커리한방병원 한방재활의학과) ;
  • 유도현 (모커리한방병원 한방재활의학과) ;
  • 김지수 (모커리한방병원 침구과) ;
  • 김태규 (모커리한방병원 침구과) ;
  • 최재영 (모커리한방병원 침구과) ;
  • 김태훈 (경희대학교 한방병원 한의약임상시험센터)
  • Received : 2016.06.16
  • Accepted : 2016.07.07
  • Published : 2016.07.31
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Abstract

Objectives The purpose of this study was to investigate the correlation between walking ability of lumbar spinal stenosis patients and the cross-sectional area (CSA) of lumbar paraspinal muscles. Methods This study was carried out on 62 lumbar spinal stenosis patients who had limited walking abilities because of neurogenic claudication (NC). All patients received more than 2 weeks of complex treatment at Mokhuri Neck&Back Hospital. CSA of lumbar paraspinal muscles was measured from axial T2-weighted MRI and divided by CSA of adjacent vertebral body to avoid influence of body statues (RCSA-Relative CSA). Pain Free Walking Distance and Numerical Rating Scale (NRS) was measured before and after treatment. Results The Pain Free Walking Distance had significantly increased in patients who had bigger RCSA of psoas muscle (r=0.313, p<0.05). Conclusions The psoas muscle can be a predictive factor for restoring walking ability of lumbar spinal stenosis patients who have limitations walking.

Keywords

References

  1. Ahn JH, Ahn JC, Ahn JK et al, Orthopaedics, 7th. ed. Seoul : Choisin Medical Publishing Co. 2013:892.
  2. Jeffrey N. Katz, Mitchel B. Harris. Lumbar Spinal Stenosis. N Engl J Med. 2008;358:818-25. https://doi.org/10.1056/NEJMcp0708097
  3. Carlo Ammendolia, Kent Stuber, Christy Tomkins-Lane, Michael Schneider, Y. Raja Rampersaud, Andrea D. Furlan, Carol A. Kennedy. What interventions improve walking ability in neurogenic claudication with lumbar spinal stenosis? A systematic review. Eur Spine J 2014;23(6):1282-301. https://doi.org/10.1007/s00586-014-3262-6
  4. Kim KO, Jeong YJ, Youn YS, Choi JC, Kim JH, Chung WS, Kim TH. Nonoperative Korean Medicine Combination Therapy for Lumbar Spinal Stenosis: A Retrospective Case-Series Study. Evid Based Complement Alternat Med 2015. Article ID 263898.
  5. Lee HI, Song J, Lee HS, Kang JY, Kim M, Ryu JS. Association between cross-sectional areas of lumbar muscles on magnetic resonance imaging and chronicity of low back pain. Ann Rehabil Med 2011;35:852-9. https://doi.org/10.5535/arm.2011.35.6.852
  6. Ward SR, Kim CW, Eng CM, Gottschalk A, Tomiya CM, Garfin SR, Lieber RL. Architectural analysis and intraoperative measurements demonstrate the unique design of the multifidus muscle for lumbar spine stability. J Bone Jt Surg Am 2009;91:176-85. https://doi.org/10.2106/JBJS.G.01311
  7. Kong DH, Bae KH, Go HY, Kang MJ, Kim JS, Yang KY, Lee JH, Eun YJ. Correlations of Cross-sectional Areas of Psoas and Paraspinal Muscles in Patients with Lumbar Disc Herniation According to the Age Groups. J Korean Med Rehab 2010;20(4):159-69.
  8. Park HS, Kim JI, Kim KW, Cho JH, Song MY. The Correlation between Cross-sectional Area of Lumbar Paraspinal Muscles and Sponylolisthesis; A Retrospective Study. J Korean Med Rehab 2016;26(1):95-102. https://doi.org/10.18325/jkmr.2016.26.1.95
  9. Chen YY, Pao JL, Liaw CK, Hsu WL, Yang RS. Image changes of paraspinal muscles and clinical correlations in patients with unilateral lumbar spinal stenosis. Eur Spine J 2014;23:999-1006. https://doi.org/10.1007/s00586-013-3148-z
  10. Rainville J, Childs LA, Pena EB, Suri P, Limke JC, Jouve C, Hunter DJ. Quantification of walking ability in subjects with neurogenic claudication from lumbar spinal stenosis--a comparative study. Spine J 2012;12(2):101-9. https://doi.org/10.1016/j.spinee.2011.12.006
  11. Lee JC, Cha JG, Kim Y, Kim YI, Shin BJ. Quantitative analysis of back muscle degeneration in the patients with the degenerative lumbar flat back using a digital image analysis: comparison with the normal controls. Spine 2008;33(3):318-25. https://doi.org/10.1097/BRS.0b013e318162458f
  12. Cooper RG, Forbes WSC, Jayson MIV. Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain. Rheumatology. 1992;31(6):389-94. https://doi.org/10.1093/rheumatology/31.6.389
  13. Zeifang F, Schiltenwolf M, Abel R, Moradi B. Gait analysis does not correlate with clinical and MR imaging parameters in patients with symptomatic lumbar spinal stenosis. BMC Musculoskelet Disord 2008;20;9:89. https://doi.org/10.1186/1471-2474-9-89
  14. Andrew J. Haig, Henry C. Tong, Karen S. J. Yamakawa, Christopher Parres, Douglas J. Quint, Anthony Chiodo, Jennifer A. Miner, Vaishali C. Phalke, Julian T. Hoff, Michael E. Geisser. Predictors of Pain and Function in Persons With Spinal Stenosis, Low Back Pain, and No Back Pain. SPINE 2006;31(25):2950-7. https://doi.org/10.1097/01.brs.0000247791.97032.1e
  15. Kuittinen P, Sipola P, Saari T, Aalto TJ, Sinikallio S, Savolainen S, Kroger H, Turunen V, Leinonen V, Airaksinen O. Visually assessed severity of lumbar spinal canal stenosis is paradoxically associated with leg pain and objective walking ability. BMC Musculoskelet Disord. 2014;15:348. https://doi.org/10.1186/1471-2474-15-348
  16. Kim YU, Kong YG, Lee JH, Cheong YS, Kim SH, Kim HK, Park JY, Suh JH. Clinical symptoms of lumbar spinal stenosis associated with morphological parameters on magnetic resonance images. Eur Spine J 2015;24(10):2236-43. https://doi.org/10.1007/s00586-015-4197-2
  17. Dangaria TR, Naesh O. Changes in Cross-Sectional Area of Psoas Major Muscle in Unilateral Sciatica Caused by Disc Herniation. Spine 1998;23(8):928-31. https://doi.org/10.1097/00007632-199804150-00016
  18. Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine 2004;29(22):E515-9. https://doi.org/10.1097/01.brs.0000144405.11661.eb
  19. Reid JG, Livingston LA, Pearsall DJ. The geometry of the psoas muscle as determined by magnetic resonance imaging. Arch Phys Med Rehabil. 1994;75(6):703-8. https://doi.org/10.1016/0003-9993(94)90199-6
  20. Bogduk N, Pearcy M, Hadfield G. Anatomy and biomechanics of psoas major. Clin Biomech 1992;7:109-19. https://doi.org/10.1016/0268-0033(92)90024-X
  21. Penning L. Psoas muscle and lumbar spine stability: a concept uniting existing controversies Critical review and hypothesis. Eur Spine J 2000;(9):577-85.
  22. Penning L. Spine stabilization by psoas muscle during walking and running. Eur Spine J 2002;(11):89-90.
  23. Christine M Comer, Anthony C Redmond, Howard A Bird, Philip G Conaghan. Assessment and management of neurogenic claudication associated with lumbar spinal stenosis in a UK primary care musculoskeletal service: a survey of current practice among physiotherapists. BMC Musculoskelet Disord 2009;10:121. https://doi.org/10.1186/1471-2474-10-121
  24. Lee HS, Shim JS, Lee ST, Kim MY, Ryu JS. Facilitating Effects of Fast and Slope Walking on Paraspinal Muscles. Ann Rehabil Med. 2014;38(4):514-22. https://doi.org/10.5535/arm.2014.38.4.514
  25. Yang DH, Woo CH, An HD. The Case Report of Korean Medicine with Flexion Exercise on Lumbar Spinal Stenosis Failed Back Surgery Syndrome. 한방척추관절학회지 2015;12(1):93-8.
  26. Han KW, Kim ES, Woo JH, Lee SJ, Lee JS, Nam JH, Kirn KW, Koh KH, Yoo IS. Clinical Observation on 119 Patients with Lumbar Spinal Stenosis Treated with Bee Venom Pharmacopuncture Therapy. The J of Korean Acupuncture & Moxibustion Society. 2011;28(3):21-31.
  27. Heo M, An JJ, Jo HK, Yoo HR, Kim YS, Seol IS. A Clinical Study of Patient with Lumbar Stenosis and Leg Length inequality by Acupuncture Treating and Chuna Treating to A-Shi Point of Iliopsoas muscle. J Korea CHUNA Manual Medicine for Spine & Nerves. 2007;2(2):69-78.

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