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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
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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.

Fig. 1.
Cross-sectional area of psoas and paraspinal muscles at the superior part of L4 level measured on MRI
acupunct-30-4-45-5-f1.gif
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.

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