Investigation Of The Role Of Multifidus Muscles In The Development Of Recurrent Lumbar Disc Herniation

ABSTRACT Introductıon: In our study, we used magnetic resonance imaging (MRI) to assess whether the atrophy of the multifidus muscle, which plays a crucial role in lumbar spine stabilization, could be prevented following a back exercise program after lumbar disc herniation surgery. Objective: This research investigated the effect of multifidus muscles that undergo atrophy after lumbar disc herniation surgeries on the development of recurrent disc herniation. Method: A total of 59 patients who underwent recurrent lumbar disc herniation surgeries were retrospectively examined. Multifidus muscle Cross-Sectional Area (CSA) and Muscle-Lamina Distance (MLD) of the patients before primary lumbar disc surgery and before recurrent surgery were measured radiologically using lumbar magnetic resonance imaging (MRI) images. Within the scope of these measurements, the effect of the multifidus muscle development exercise program application after lumbar disc herniation surgeries on the development of recurrent discs was statistically evaluated. Results: The MLD measurement of the multifidus muscle before primary lumbar disc herniation surgery was not statistically significant between the exercise and non-exercise groups, while the MLD measurement of the multifidus muscle on the pathological disc side before lumbar recurrent disc surgery (p= 0.017) was statistically significant between the exercise and non-exercise groups. In the measurements taken by the first observer before lumbar recurrent disc herniation surgery, the mean MLD measurement of the multifidus muscle in the exercise group was 5.34. In contrast, the mean MLD measurement of the multifidus muscle in the non-exercise group was 6.83, which was statistically significant (p= 0.017). In addition, the first observer's measurement of the upper pathological disc distance before lumbar recurrent disc herniation surgery was statistically significant (p= 0.024). According to the evaluation made by the second observer, the mean MLD measurement of the multifidus muscle before lumbar recurrent disc herniation surgery was 5.56 in the exercise group. At the same time, it was 6.81 in the non-exercise group (p= 0.038), same result as the first observer. Conclusion: Our study shows that exercise shortens the MLD distance and that an appropriate lumbar exercise program can prevent multifidus muscle atrophy. Keywords: Lumbar Disc Herniation, Multifidus Muscle, Cross-Sectional Area (CSA) and Muscle-Lamina Distance (MLD), Exercise Program.