Nathan Peled MD, Presenter: Nothing to Disclose

Tamar Gaspar MD, Abstract Co-Author: Nothing to Disclose

Debora Alperovitch-Najenson , Abstract Co-Author: Nothing to Disclose

Leonid Kalichman , Abstract Co-Author: Nothing to Disclose

Dror Robinson , Abstract Co-Author: Nothing to Disclose

Israel Hershkovitz PhD, Abstract Co-Author: Nothing to Disclose

Smadar Peleg, Abstract Co-Author: Nothing to Disclose

Yosef Masharawi, Abstract Co-Author: Nothing to Disclose

Noam Steinberg, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Many attempts have been made to allocate common factors that link low back pain (LBP) to precise etiology. There is growing evidence that muscle dysfunction may be involved in the etiology of LBP. Muscle cross-sectional area (CSA) is commonly used as an indicator of the muscles' physiological status (force). As this criterion suffers from many deficits, we here suggest a method for evaluating muscle density (MD)in order to find the relationship between spinal muscle atrophy (Assessed by CT) and LBP.

169 patients (89 males and 80 females, age 17-85, mean 51±16) suffering from chronic LBP and 42 controls (20 males and 22 females, age 18-74, mean 43±16) who underwent CT examination were included in the study. Age, gender, height and weight were recorded and body mass index calculated. A CT scan protocol was used to measure both the CSA and MD of the three abdominal muscles [psoas major (PM), multifidus (MF) and erector spinae (ES)], using a 'threshold’ technique (bone and fat tissue eliminated) and CT density (in Hounsfield units) respectively. Logistic regression analysis was used to compare between groups (with and without low back pain). Pearson correlation between CSA, MD and age were calculated.

Statistical differences between the two groups were found only in regard to muscle density (for all three muscles and both sides). Muscle CSA did not differ between the groups. Muscle CSA was correlated with age in the group with LBP (p<0.001) but not in the group without pain. Muscle density was significantly correlated with age in both groups; nevertheless, correlation coefficients were much higher in the former.

It seems that muscle deterioration (sarcopenia) is associated with LBP. It is impossible to receive a definitive answer because of the small sample of our controls. Muscle density seems to be a more sensitive tool to differ between individuals with and without LBP and to detect muscle deterioration with age. Psoas major muscle seems to be less affected by age than MF and ES.

Objective: To reveal the relationship between spinal muscle atrophy (Assessed by CT) and low back pain

Peled, N, Gaspar, T, Alperovitch-Najenson , D, Kalichman , L, Robinson , D, Hershkovitz, I, Peleg, S, Masharawi, Y, Steinberg, N, et al, , Muscle Atrophy and Low Back Pain: A CT Study.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433320.html