Evaluation of the paraspinal muscles mophology using magnetic resonance imaging in adult patients with nonspecific chronic low back pain in Port Harcourt Rivers State Nigeria

Background: Nonspecific chronic low back pain (CLBP) is a major public health concern globally and the leading cause of musculoskeletal disability, affecting mainly adults in their productive years with a high economic impact in the society. Objective: This study was designed to evaluate the changes in the paraspinal muscles (lumbar multifidus) morphology using data obtained from MRI of the lumbosacral spine in adult participants with non-specific chronic low back pain. Materials and methods: This was a cross-sectional study, involving 200 adult participants with non-specific chronic low back pain undergoing MRI of the lumbosacral spine at the Department of Radiology, Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria, during a six months period. Data recorded include lumbar multifidus muscle (LMM) morphology and lumbar spine pathologies Results: The LMM CSA for L1, L2, L3, L4 and L5 were 2.24±0.84, 3.59±1.15, 5.18±1.60, 6.66±1.75 and 7.27±2.62 respectively. The frequency distribution of LMM fatty infiltration in percentage showed Grade 0 was highest at L1 (86.5%, n= 173) and lowest at L5 (6.5%, n=13); Grade 1 was highest at L4 (73%, n=146) and lowest at L1 (13.5%, n=2) and Grade 2 was highest at L5 (22.5%, n=45) and lowest at L1 (0.0%, n=0). The lumbar pathologies noted were 200(100%) disc abnormalities, while 178(89.0%) had neural foraminal narrowing, nerve root compression and spinal canal stenosis each. Facet joint arthrosis and spondylosis were 177(88.5%) and 176(88.0%) respectively. Conclusion: Dysfunctional LMM was observed to increase with advancing age, severe in females and individuals with elevated BMI and cuts across various occupations. Measures aimed at improving and maintaining the quality of the LMM should be encouraged, as this will help in reducing the prevalence of nonspecific CLBP