Inconsistent descriptions of lumbar multifidus morphology

Autor: André Wolff, Hermie J. Hermens, Frits G. J. Oosterveld, Heiko Wagner, Gerbrand J. Groen, Remko Soer, Anke Hofste
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Scoping review
lcsh:Diseases of the musculoskeletal system
Evaluation system
Research methodology
SHEAR-WAVE ELASTOGRAPHY
Paraspinal Muscles
MOTOR CONTROL EXERCISES
Thoracolumbar fascia
Lumbar vertebrae
Erector spinae
03 medical and health sciences
0302 clinical medicine
Lumbar
Rheumatology
PREDICT CLINICAL-OUTCOMES
medicine
Humans
Orthopedics and Sports Medicine
Magnetic resonance imaging (MRI)
NEUROMUSCULAR ELECTRICAL-STIMULATION
TRANSVERSUS ABDOMINIS MUSCLE
low back pain
Ultrasonography
CROSS-SECTIONAL AREA
Lumbar Vertebrae
medicine.diagnostic_test
business.industry
Lumbar multifidus
Lumbosacral Region
Magnetic resonance imaging
Exercise therapy
030229 sport sciences
Anatomy
RANDOMIZED CONTROLLED-TRIAL
Low back pain
Magnetic Resonance Imaging
medicine.anatomical_structure
PARASPINAL MUSCLE MORPHOLOGY
SAGITTAL SPINAL ALIGNMENT
lcsh:RC925-935
medicine.symptom
business
Computer Tomography
030217 neurology & neurosurgery
Research Article
LOW-BACK-PAIN
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-18 (2020)
ISSN: 1471-2474
Popis: Background Lumbar multifidus (LM) is regarded as the major stabilizing muscle of the spine. The effects of exercise therapy in low back pain (LBP) are attributed to this muscle. A current literature review is warranted, however, given the complexity of LM morphology and the inconsistency of anatomical descriptions in the literature. Methods Scoping review of studies on LM morphology including major anatomy atlases. All relevant studies were searched in PubMed (Medline) and EMBASE until June 2019. Anatomy atlases were retrieved from multiple university libraries and online. All studies and atlases were screened for the following LM parameters: location, imaging methods, spine levels, muscle trajectory, muscle thickness, cross-sectional area, and diameter. The quality of the studies and atlases was also assessed using a five-item evaluation system. Results In all, 303 studies and 19 anatomy atlases were included in this review. In most studies, LM morphology was determined by MRI, ultrasound imaging, or drawings – particularly for levels L4–S1. In 153 studies, LM is described as a superficial muscle only, in 72 studies as a deep muscle only, and in 35 studies as both superficial and deep. Anatomy atlases predominantly depict LM as a deep muscle covered by the erector spinae and thoracolumbar fascia. About 42% of the studies had high quality scores, with 39% having moderate scores and 19% having low scores. The quality of figures in anatomy atlases was ranked as high in one atlas, moderate in 15 atlases, and low in 3 atlases. Discussion Anatomical studies of LM exhibit inconsistent findings, describing its location as superficial (50%), deep (25%), or both (12%). This is in sharp contrast to anatomy atlases, which depict LM predominantly as deep muscle. Within the limitations of the self-developed quality-assessment tool, high-quality scores were identified in a majority of studies (42%), but in only one anatomy atlas. Conclusions We identified a lack of standardization in the depiction and description of LM morphology. This could affect the precise understanding of its role in background and therapy in LBP patients. Standardization of research methodology on LM morphology is recommended. Anatomy atlases should be updated on LM morphology.
Databáze: OpenAIRE
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