The Effect of Conventional Lumbar Spine Surgery on the Lumbar Multifidus Fat Infiltration

Abstract

Aims: Low back pain is considered as a common problem that affects most adults at least once in their lives. Almost 90% of people experience back pain during their lifetime. The total cost of treating chronic low back pain in the United States is estimated at more than $ 100 billion annually. Hence, the present study aimed to investigate the effect of lumbar spine surgery on the lumbar multifidus fat infiltration in the patients referred to Imam Reza Hospital in 2020. Study Design: Prospective study. Place and Duration of Study: Department of Neurosurgery, AJA University of Medical Sciences (AJAUMS), Imam-Reza Hospital, Tehran between January 2020 and January 2021. Methodology: In the present prospective study, patients with disk herniation or lumbar spine canal stenosis referred to the neurosurgery clinic of Imam Reza Hospital in 2020 that underwent surgery were enrolled. After six months, they underwent lumbosacral MRI again. Multifidus muscles in primary MRI and sixth month MRI were compared at L4-L5 and L5-S1 levels and the changes were recorded. Results: A total number of 288 patients were enrolled in the present study during the study period. Based on the results, moderate fat infiltration (grade II) have had the highest frequency amongst the patients, and 52% of patients were in the moderate state in terms of adipose tissue infiltration in multifidus muscle postoperatively. Conclusion: Increased adipose tissue infiltration in the postoperative period was high and can be considered as a cause of disability and severe pain in patients after surgery. Due to the muscle atrophy six months post-surgery owing to intraoperative muscle injuries and consequently postoperative movement restriction, some exercises and physical therapy can be suggested to correct movement patterns and further reduce pain in the patients.