title: Asymmetry of the multifidus muscle in lumbar radicular nerve compression.
abstract: OBJECTIVE
  The multifidus muscle is the only paraspinal lumbar muscle that is innervated by a single nerve root. This study aimes to evaluate if the asymmetry of the multifidus muscle is related to the severity of compression of the nerve root or the duration of radiculopathy.
  
  
  METHODS
  MRI scans of 79 patients with symptomatic single level, unilateral, lumbar radiculopathy were reviewed for this retrospective case series with a nested case-control study. The cross-sectional area (CSA) of the multifidus muscle and the perpendicular distance of the multifidus to the lamina (MLD) were measured bilaterally by two radiologists and set into relation to the severity of nerve compression, duration of radiculopathy and probability of an indication for surgical decompression.
  
  
  RESULTS
  In 67 recessal and 12 foraminal symptomatic nerve root compressions, neither the MLD ratio (severe 1.19 ± 0.55 vs less severe nerve compression: 1.12 ± 0.30, p = 0.664) nor the CSA ratio (severe 1 ± 0.16 vs less severe 0.98 ± 0.13, p = 0.577) nor the duration of symptoms significantly correlated with the degree of nerve compression. MR measurements of multifidus were not different in patients with (n = 20) and those without (n = 59) clinical muscle weakness in the extremity caused by nerve root compression. A MLD >1.5 was, however, associated with the probability of an indication for surgical decompression (OR 3, specificity 92%, PPV 73%).
  
  
  CONCLUSIONS
  Asymmetry of the multifidus muscle correlates with neither the severity nor the duration of nerve root compression in the lumbar spine. Severe asymmetry with substantial multifidus atrophy seems associated with the probability of an indication of surgical decompression.
authors.affiliation: Balgrist University Hospital, University of Zürich, Forchstrasse 340, 8008, Zürich, Switzerland, mazda.farshad@balgrist.ch.
authors.forename: Mazda
authors.initials: M
authors.lastname: Farshad
authors.forename: Christian
authors.initials: C
authors.lastname: Gerber
authors.forename: Nadja A
authors.initials: NA
authors.lastname: Farshad-Amacker
authors.forename: Tobias J
authors.initials: TJ
authors.lastname: Dietrich
authors.forename: Viviane
authors.initials: V
authors.lastname: Laufer-Molnar
authors.forename: Kan
authors.initials: K
authors.lastname: Min
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000209:etiology* / Q000473:pathology*; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000473:pathology*; D064170:Paraspinal Muscles / Q000473:pathology*; D011843:Radiculopathy / Q000150:complications* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult