European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
Association of paraspinal and psoas muscle morphology with recurrent lumbar disc herniation: a retrospective case-control study.
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Tekin Abdurrahim, Can Engin, Edehan Enis Furkan, Hazar Necati Uğur, Ayhan Lokman, Sönmez Evren, Dilbaz Suna, Öztürk Akın, Baş Nuri Serdar, Çevik Serdar
Аннотация
PURPOSE: This study aimed to investigate the association between the morphology of paraspinal and psoas muscles and recurrent lumbar disc herniation (rLDH) using quantitative preoperative MRI analysis..
METHODS: A retrospective analysis was conducted on 43 patients with rLDH and 43 matched controls who had undergone surgery for lumbar disc herniation (LDH). Quantitative measurements of the multifidus (MF), erector spinae (ES), and psoas (PS) muscles were performed, including functional cross-sectional area (FCSA), fat infiltration (FI), and relative FCSA (rFCSA). .
RESULTS: The FCSA values of MF and ES muscles were significantly lower in the rLDH group compared to controls, while the PS muscle exhibited higher FCSA values. Multivariate analysis revealed that increased MF FCSA had a protective effect against rLDH (OR = 0.665, p < 0.001), whereas increased PS FCSA was a significant risk factor (OR = 1.15, p < 0.001).
CONCLUSION: Degeneration of the multifidus muscle and hypertrophy of the psoas were significantly associated with recurrence of LDH, whereas erector spinae degeneration did not show a significant independent effect in multivariate analysis. These findings emphasize the importance of maintaining paraspinal muscle health to prevent rLDH. Further prospective studies are needed to confirm these results and explore targeted interventions for muscle function improvement.
METHODS: A retrospective analysis was conducted on 43 patients with rLDH and 43 matched controls who had undergone surgery for lumbar disc herniation (LDH). Quantitative measurements of the multifidus (MF), erector spinae (ES), and psoas (PS) muscles were performed, including functional cross-sectional area (FCSA), fat infiltration (FI), and relative FCSA (rFCSA). .
RESULTS: The FCSA values of MF and ES muscles were significantly lower in the rLDH group compared to controls, while the PS muscle exhibited higher FCSA values. Multivariate analysis revealed that increased MF FCSA had a protective effect against rLDH (OR = 0.665, p < 0.001), whereas increased PS FCSA was a significant risk factor (OR = 1.15, p < 0.001).
CONCLUSION: Degeneration of the multifidus muscle and hypertrophy of the psoas were significantly associated with recurrence of LDH, whereas erector spinae degeneration did not show a significant independent effect in multivariate analysis. These findings emphasize the importance of maintaining paraspinal muscle health to prevent rLDH. Further prospective studies are needed to confirm these results and explore targeted interventions for muscle function improvement.