The lumbar multifidus muscle in polysegmentally innervated.
We conducted a prospective case study to determine whether the lumbar multifidus muscle is polysegmentally innervated. A 49-year-old man with chronic mechanical low back pain underwent bilateral percutaneous radiofrequency neurotomy of the medial branches of the L3 dorsal rami. Electromyography (EMG) examination was performed in the L2-5 multifidi both prior to and 3 weeks after the procedure. Positive sharp waves and fibrillations appeared in the L3-L5 multifidi after the neurotomy. This study provides electrophysiological evidence in the human lumbar spine that the medial branch of the lumbar root innervates the multifidus muscle at multiple levels, i.e., the lumbar multifidus muscle is polysegmentally innervated. As a result, electromyography of the multifidus cannot identify a specific level of lumbar radiculopathy.
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Department of Physical Medicine and Rehabilitation, Palo Alto Medical Clinic, Palo Alto, California, USA.
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Kingery
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D003714:Denervation; D004576:Electromyography; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000294:innervation; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation*; D013126:Spinal Nerve Roots / Q000503:physiopathology