SONOGRAPHIC ASSESSEMENT OF LUMBAR MULTIFIDUS MUSCLE IN PATIENTS WITH CHRONIC LOW BACK PAIN IN KANO, NIGERIA
INTRODUCTION: Low back pain is a serious disabling health problem that is responsible for morbidity and economic losses. Lumbar multifidus muscle is responsible for stability of the spine and may atrophy in chronic low back pain. Ultrasonography is a non- invasive method of measuring the cross-sectional area of lumbar multifidus, which could potentially grade the severity of low back pain.
Aims and Objectives:
To evaluate chronic low back pain by determining the cross-sectional area of the lumbar multifidus in symptomatic and asymptomatic subjects at the level of L5 lumbar vertebra using ultrasound imaging.
Materials and Method:
The prospective study was conducted over six months in Aminu Kano Teaching Hospital, Kano. One hundred patients with chronic low back pain and one hundred healthy controls were recruited for this study. After documenting the age, sex and side of low back pain of the subjects, the subjects were scanned with high resolution transducer. The cross-sectional area and thickness of the lumbar multifidus muscle was determined and documented.
Among the study group, the mean CSA and standard deviation of right lumbar multifidus muscle measured 2.70±0.86cm2, while the left measured 2.74±0.97cm2; whereas mean CSA control group measured 4.86±1.09cm2 and 4.83±1.11cm2 on the respective right and left. The mean thickness and standard deviation in CLBP measured 2.00±0.45cm and 2.02±0.48cm on the respective right and left side, while in controls measured 2.69±0.40cm and 2.69±0.40cm on the respective right and left side. There is significance decrease in the CSA and thickness of lumbar multifidus muscle in CLBP compared with asymptomatic controls.
This study show that the cross sectional area of multifidus muscle is smaller in chronic low back pain patients when compared with controls. This deference is useful clinically in establishment of exact point of pathology in these patients.