Changes in the cross-sectional area of multifidus and psoas in unilateral sciatica caused by lumbar disc herniation

Abstract

Objective: To quantitatively evaluate the asymmetry of the multifidus and psoas muscles in unilateral sciatica caused by lumbar disc herniation using magnetic resonance imaging (MRI).

Methods: Seventy-six patients who underwent open microdiscectomy for unilateral L5 radiculopathy caused by disc herniation at the L4-5 level were enrolled, of which 39 patients (51.3%) had a symptom duration of 1 month or less (group A), and 37 (48.7%) had a symptom duration of 3 months or more (group B). The cross-sectional areas (CSAs) of the multifidus and psoas muscles were measured at the mid-portion of the L4-5 disc level on axial MRI, and compared between the diseased and normal sides in each group.

Results: The mean symptom duration was 0.6±0.4 months and 5.4±2.7 months for groups A and B, respectively (p<0.001). There were no differences in the demographics between the 2 groups. There was a significant difference in the CSA of the multifidus muscle between the diseased and normal sides (p<0.01) in group B. In contrast, no significant multifidus muscle asymmetry was found in group A. The CSA of the psoas muscle was not affected by disc herniation in either group.

Conclusion: The CSA of the multifidus muscle was reduced by lumbar disc herniation when symptom duration was 3 months or more.

Keywords: Cross-sectional area; Lumbar disc herniation; Multifidus; Psoas.

Fig. 1

Cross-sectional area measurement of the multifidus (A) and psoas (B) muscles using a magnetic resonance imaging at the L4-5 intervertebral disc level.