PM&R
Volume 1, Issue 8 , Pages 719-722 , August 2009

The Significance of Multifidus Atrophy After Successful Radiofrequency Neurotomy for Low Back Pain

  • Paul Dreyfuss, MD

      Affiliations

    • Clinical Professor, Department of Rehabilitation Medicine, University of Washington, 21108 NE 129th CT, Woodinville, WA 98077†
    • Corresponding Author InformationAddress correspondence to: P.D.
    • ,
  • Alison Stout, DO

      Affiliations

    • Acting Assistant Professor, Veterans Affairs Health Care Services, Department of Rehabilitation Medicine, University of Washington, Seattle, WA‡
    • ,
  • Charles Aprill, MD

      Affiliations

    • Magnolia Diagnostics, New Orleans, LA§
    • ,
  • Steve Pollei, MD

      Affiliations

    • Center for Diagnostic Imaging, Tacoma, WA
    • ,
  • Blake Johnson, MD

      Affiliations

    • Center for Diagnostic Imaging, St. Louis Park, MN∥
    • ,
  • Nikolai Bogduk, MD, PhD

      Affiliations

    • University of Newcastle, Newcastle Bone and Joint Institute, Royal Newcastle Centre, Newcastle, New South Wales, Australia#

Received 17 November 2008 ,Accepted 26 May 2009.

References 

  1. Macintosh JE, Valencia F, Bogduk N, Munro RR. The morphology of the lumbar multifidus muscles. Clin Biomech. 1986;1:196–204
  2. Macintosh JE, Bogduk N. The biomechanics of the lumbar multifidus. Clin Biomech. 1986;1:205–213
  3. Goel VK, Kong W, Han JS, et al. A combined finite element and optimization investigation of lumbar spine mechanics with and without muscles. Spine. 1993;18:1531–1541
  4. Panjabi M, Abumi K, Duranceau J, et al. Spinal stability and intersegmental muscle forces: a biomechanical model. Spine. 1989;14:194–200
  5. Wilke HJ, Wolf S, Cles LE, Arand M, Wiesend A. Stability increase of the lumbar spine with different muscle groups (A biomechanical in vitro study). Spine. 1995;20:192–198
  6. Crisco JJ, Panjabi MM. The intersegmental and multisegmental muscles of the lumbar spine: a Biomechanical model comparing lateral stabilizing potential. Spine. 1991;16:793–799
  7. Steffen R, Nolte LP, Pingel TH. Rehabiliation of post-operative segmental lumbar instability (A biomechanical analysis of the rank of the back muscles). Rehabilitation. 1994;33:164–170
  8. Sirca A, Kostevc V. The fibre type composition of thoracic and lumbar paravertebral muscles in man. J Anat. 1985;141:131–137
  9. Kader DF, Wardlaw D, Smith FW. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol. 2000;55:145–149
  10. Hides JA, Stokes MJ, Saide M, Jull GA, Cooper DH. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine. 1994;19:165–172
  11. Hides JA, Richardson CA, Jull GA. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine. 1996;21:2763–2769
  12. Hides JA, Stanton WR, McMahon S, Sims K, Richardson CA. Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain. J Orthop Sports Phys Ther. 2008;38:101–108
  13. Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multfidus and psoas in patients with unilateral back pain: The relationship to pain and disability. Spine. 2004;29:515–519
  14. Hides JA, Jull GA, Richardson CA. Long term effects of specific stabilizing exercises for first episode low back pain. Spine. 2001;26:243–248
  15. Mikeladze G, Espinal R, Finnegan R, Routon J, Martin D. Pulsed radiofrequency application in treatment of chronic zygapophyseal joint pain. Spine J. 2003;3:360–362
  16. Daneels LA, Vanderstraeten GG, Cambier DC, Witrvrouw EE, DeCuyper HJ. CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J. 2000;9:266–272
  17. Dreyfuss P, Halbrook B, Pauza K, Joshi A, McLarty J, Bogduk N. Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine. 2000;25:1270–1277
  18. International Spine Intervention Society. Lumbar Medial Branch Blocks. In:  Bogduk N editors. Practice Guidelines for Spinal Diagnostic and Treatment Procedures. San Francisco, CA: International Spine Intervention Society; 2004;p. 47–65
  19. Haig AJ. Clinical experience with paraspinal mapping II: A simplified technique that eliminates three-fourths of needle insertions. Arch Phys Med Rehabil. 1997;78:1185–1190
  20. International Spine Intervention Society. Percutaneous Radiofrequency Lumbar Medial Branch Neurotomy. In:  Bogduk N editors. Practice Guidelines for Spinal Diagnostic and Treatment Procedures. San Francisco, CA: International Spine Intervention Society; 2004;p. 188–218

 This CME activity is designated for 1.0 AMA PRA Category 1 Credit™ and can be completed online at me.aapmr.org. Log on to www.me.aapmr.org, go to Lifelong Learning (CME) and select Journal-based CME from the drop down menu. At $10 per activity for AAPM&R members, journal CME is a cost-effective option for obtaining Category 1 CME credit!

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

 This study was funded by a grant from the International Spinal Intervention Society (ISIS). This study was also possible through the generosity of the ETMC Neurological Institute and HealthSouth Imaging in Tyler, Texas.

PII: S1934-1482(09)00546-2

doi: 10.1016/j.pmrj.2009.05.014

PM&R
Volume 1, Issue 8 , Pages 719-722 , August 2009

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