CT and MRI evaluation of paraspinal muscle degeneration

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-2114

Type:

Educational Exhibit

Keywords:

Tissue characterisation, Technical aspects, MR, CT, Musculoskeletal system, Musculoskeletal spine

Authors:

B. Upadhyay¹, A. P. Toms²; ¹Basildon/UK, ²Norwich/UK

DOI:

10.1594/ecr2015/C-2114

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-2114

Fig. 1: (a,b) The multifidus (MF) is medial to the erector spinae ES muscle which...

Fig. 2: Goutallier and simplified 3-tier grading systems with representative images.

Fig. 3: ROIs for MF, ES and total paraspinal muscle group described by Fortin et al...

Fig. 4: Threshold technique used to calculate functional cross sectional area. ...

Learning objectives

To recognise the clinical importance of paraspinal muscle degeneration and the association with lower back pain (LBP). To compare the strengths and limitations of the techniques used to evaluate paraspinal muscle degeneration on CT and MRI.

Background

The lumbar paraspinal muscles comprise two main groups, the transversospinales, which includes the mulitifidus muscle (MF), and more laterally, the erector spinae (ES) muscles which consist of the longissimus and iliocostalis muscles (1–3) (Fig. 1). The paraspinal muscles have an important role in trunk movement and spinal stability (4,5). In particular the MF has a large physiological cross sectional area. This allows significant forces to be generated, making it critical for spinal stability (6). Paraspinal muscle degeneration could therefore result in spinal instabilitiy which may...

Findings and procedure details

We summarise the different methods described to evaluate paraspinal muscle degeneration using CT and MRI with comparison of the strengths and limitations of each technique. Qualitative Methods 1. Goutallier classification: Qualitative grading system initially described to evaluate fatty degeneration of the rotator cuff using CT (Grade 0: no fatty deposits, Grade 1: some fatty streaks, Grade 2: muscle > fat, Grade 3: muscle = fat, Grade 4: muscle < fat). (9) Similar grading systems described for the evaluation of paraspinal muscle atrophy (10–13) (Fig. 2)....

Conclusion

Multiple methods for the evaluation of paraspinal muscle have previously been described however there is a clear need for a simple and reliable technique that can be adopted for routine use to help in the assessment and management of patients with LBP.

Personal information

References

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