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Impact of Multifidus Muscle Morphometry on the Clinical Evolution of Chronic Low Back Pain

Forensic Medicine and Anatomy Research 2023年第1期11卷 1-13页

作者： Ndèye Bigué Mar Aïnina Ndiaye Abdoulaye Ndoye Diop gor side diagne Babacar Diao Souleymane Diao Racky Wade Issa Dior Seck Karim Yacouba Garba Sokhna Astou Gawane Thiam Mamadou Ndiaye Magaye Gaye Magatte Gaye Sakho Jean Marc Ndiaga Ndoye Mamadou Diop Assane Ndiaye Abdoulaye Ndiaye Anatomy Laboratory/Joint Research and Diagnosis Unit Iba Der THIAM University of Thiès Thiès Senegal Laboratory and Organogen of Anatomy Cheikh Anta Diop University of Dakar Dakar Senegal Department of Radiology and Medical Imaging Gaston Berger University of Saint Louis Dakar Senegal Neurology Department Fann Hospital in Dakar Dakar Senegal Urology Service Ouakam Military Hospital Dakar Senegal Orthopedic Traumatology Service Idrissa Pouye Hospital of Grand Yoff-Dakar Dakar Senegal Neurosurgery Department Idrissa Pouye Hospital of Grand Yoff Dakar Senegal Anatomy Laboratory Assane Seck University of Ziguinchor Ziguinchor Senegal

Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm3 ± 39, after physiotherapy it was 203 mm3 ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.

关键词： Morphometry Multifidus Low Back Pain Physiotherapy

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