Article

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.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS