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PubMed1994

Input patterns and pathways from the six semicircular canals to motoneurons of neck muscles. I. The multifidus muscle group.

1. The pattern of connections between the six semicircular canals and neck motoneurons of the multifidus muscle group was investigated by recording intracellular potentials from motoneurons in the upper cervical cord of anesthetized cats. 2. Synaptic potentials were recorded in motoneurons of the rectus capitis posterior (RCP) muscle at C1, the obliquus capitis inferior (OCI) muscle at C1 and C2, and the cervical multifidus muscle (Multi) at C4 in response to electrical stimulation of individual ampullary nerves of the six semicircular canals. Excitatory or inhibitory postsynaptic potentials (EPSPs or IPSPs, respectively) were evoked by separate stimulation of individual ampullary nerves in all of the neck motoneurons. Virtually all of the neck motoneurons received convergent inputs from the six ampullary nerves. 3. Motoneurons that supplied a single muscle had a homogeneous pattern of input from the six semicircular canals. There were two patterns of input from the six semicircular canals to motoneurons of the multifidus muscle group. RCP and Multi motoneurons were excited by stimulation of the bilateral anterior canal nerves (ACNs) and the contralateral lateral canal nerve (LCN) and inhibited by stimulation of the bilateral posterior canal nerves (PCNs) and the ipsilateral LCN. This input pattern is similar to that previously observed in other dorsal extensor muscles, whereas the other input pattern observed in OCI motoneurons is entirely new. OCI motoneurons at C1 and C2 were excited by stimulation of the ipsilateral ACN, PCN, and the contralateral LCN and inhibited by stimulation of the contralateral ACN, PCN, and the ipsilateral LCN. 4. Most postsynaptic potentials (PSPs) were disynaptic, but there were trisynaptic inhibitory connections between the contralateral ACN and PCN and OCI motoneurons, and between the contralateral PCN and RCP motoneurons. 5. The pathways for mediating these inputs from different semicircular canals to neck motoneurons were determined by making lesions in the lower medulla. Transection of the ipsilateral medial longitudinal fascicle (MLF) abolished the following potentials: all disynaptic PSPs in RCP motoneurons except the disynaptic EPSPs from the ipsilateral ACN, and in OCI motoneurons, disynaptic PSPs from the bilateral LCNs, and disynaptic IPSPs from the contralateral PCN. Complete bilateral section of the MLF did not affect the disynaptic EPSPs from the ipsilateral ACN in RCP motoneurons, the disynaptic EPSPs from the ipsilateral ACN and PCN in OCI motoneurons, nor the trisynaptic IPSPs from the contralateral ACN and PCN in COI motoneurons and from the contralateral PCN in RCP motoneurons.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2003

Atrophy of the multifidus muscle in patients with lumbar disk herniation: histochemical and electromyographic study.

A histochemical and electromyographic study of the lumbar multifidus muscle in 17 patients with L4-L5 lumbar disk herniation was performed. Electromyography (EMG) was recorded preoperatively with a needle electrode according to Haig's method. Biopsy specimens were obtained intraoperatively from the L5 band of the multifidus muscle on the affected and unaffected sides. Patients with lumbar disk herniation showed atrophy of type 1 and type 2 fibers with structural changes in the multifidus muscle at the involved level. Furthermore, patients with abnormal EMG results had severe muscle atrophy compared with patients with normal EMG results.

Adult↗
PubMed1987

[Distribution pattern of lumbar epaxial, especially M. multifidus motoneurons in the spinal cord of the cat: a study by the retrograde horseradish peroxidase method].

Distribution patterns of motoneurons supplying the lumbar epaxial muscles in the spinal ventral horn have been investigated by the retrograde horseradish peroxidase (HRP) method in 6 cats. HRP (30-40%, 3.0-5.7 mg) injections into multifidus muscle in 5 cases, and for comparison, longissimus lumborum muscle in one case were made at vertebral levels from L5 to L7 at multiple sites. After two days, the animals were sacrificed and frozen sections (60 microns thick) in the frontal plane of the spinal cord were made from the L1 to L7 segments and each section reacted histochemically with the tetramethylbenzidine (TMB) method. The results are summarized as follows. Following HRP injections into the multifidus muscle, labeled cells were found in the ventral horn rostrocaudally from the L2 to L6 segments. Total number of labeled cells ranged from 176 to 436 on the injected side. Labeled cells were most numerous in the L4 segment (range: 98-244). Labeled cells were found on the medial side of the ventral horn, especially in the ventromedial part (VM), predominantly ipsilateral to the injected muscle. Following HRP injection into the longissimus lumborum muscle in one case, labeled cells were also found on the medial side, but were more restricted in the centromedial part (CM) of the ventral horn. In all cases with HRP injection into the multifidus muscle, labeled cells were occasionally observed in VM and/or the medial ventral column (VC) contralateral to the injected muscle in L3 and/or L4 segment. The total number of these cells ranged from 2 to 66. These contralaterally labeled cells were presumed to be due to the peripheral HRP spread. Labeled cells observed in VM and CM were fusiform and round in shape, respectively. These cells had mean average soma diameters (ASD) from 32 to 40 microns and were presumed to be alpha motoneurons. A few labeled cells observed in VC were fusiform in shape and were significantly smaller (mean ASD: 23-28 microns) than the cells observed in other areas (VM, CM). In some cases, the dendrites of labeled cells in VM and VC extended dorsomedially in the VC across the midline in the anterior white commissure.

Animals↗
PubMed1989

Muscle fibre direction of longissimus, iliocostalis and multifidus: landmark-derived reference lines.

Considerable inter-individual variations in the fibre direction angles of the iliocostalis lumborum, longissimus and multifidus were observed, thus bringing the applicability of a two dimensional fixed angle grid system for fibre direction determination into question. However, the angulation of the fibres of the multifidus and iliocostalis lumborum were found to be easily identifiable by the use of three surface anatomical landmarks: the caudal tip of the superior iliac spine, the lateral border of the iliocostalis at the twelfth rib and the L1-L2 interspinous space. No reliable index was found for the longissimus. Suggested electrode placement sites for the electromyographic study of the iliocostalis lumborum and the multifidus are at the levels of the L2-L3 and the L4-L5 interspinous spaces respectively.

Biometry↗
PubMed1998

Focal atrophy of the multifidus muscle in lumbosacral radiculopathy.

A patient with compelling clinical and electrodiagnostic evidence of a right L5 radiculopathy had focal atrophy of the multifidus at the appropriate level, which served to confirm the radicular nature of the process. The multifidus muscles are innervated by a single root, in contrast to the polysegmental innervation of the rest of the paraspinal muscle mass. Imaging studies may complement needle electromyography in the evaluation of this important structure.

Electromyography↗
PubMed2005

Intramuscular pressure, tissue oxygenation and EMG fatigue measured during isometric fatigue-inducing contraction of the multifidus muscle.

Simultaneous measurement of intramuscular pressure (IMP), tissue oxygen partial pressure (pO(2)) and EMG fatigue parameters in the multifidus muscle during a fatigue-inducing sustained muscular contraction. The study investigated the following hypotheses: (1) Increases in IMP result in tissue hypoxia; (2) Tissue hypoxia is responsible for loss of function in the musculature. The nutrient supply to muscle during muscle contraction is still not fully understood. It is assumed that muscle contraction causes increased tissue pressure resulting in compromised perfusion and tissue hypoxia. This tissue hypoxia, in turn, leads to muscle fatigue and therefore to loss of function. To the authors' knowledge, no study has addressed IMP, pO(2) and EMG fatigue parameters in the same muscle to gain a deeper sight into muscle perfusion during contraction. As back muscles need to have a constant muscular tension to maintain trunk stability during stance and locomotion, muscle fatigue due to prolonged contraction-induced hypoxia could be an explanation for low back pain. Sixteen healthy subjects performed an isometric muscular contraction exercise at 60% of maximum force until the point of localized muscular fatigue. During this exercise, the individual changes of IMP, pO(2) and the median frequency (MF) of the surface EMG signal of the multifidus muscle were recorded simultaneously. In 12 subjects with a documented increase in intramuscular pressure, only five showed a decrease in tissue oxygen partial pressure, while this parameter remained unchanged in six other subjects and even increased in one. A fall in tissue pO(2) was associated with a drop in MF in only five subjects, while there was no correlation between these parameters in the other 11 subjects. To summarize, an increase in IMP correlated with a decrease in pO(2) and a drop in MF in only five out of 16 subjects. High intramuscular pressure values are not always associated with a hypoxia in muscle tissue. Tissue hypoxia is not automatically associated with a median frequency shift in the EMG signal's power spectrum.

Adult↗
PubMed1993

The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation.

Biopsy specimens of the lumbar multifidus were obtained from 18 patients with lumbar disc herniation at operation and after a postoperative follow-up period of 5 years. The structure and morphometry of the muscle fibers were analyzed and these data were compared with intraoperative biopsy results and the clinical outcome of the operation. The main findings were: 1) on the basis of occupational handicap score 10 patients belonged in the "positive" and 8 in the "negative" outcome group; 2) the intraoperatively recorded selective type 2 muscle fiber atrophy and the extent of pathologic inner structure changes both decreased in the "positive" outcome group, whereas they persisted in the "negative" group; 3) grouping as a definite sign of reinnervation was seen in only two versus four patients of the "positive" versus "negative" outcome group; 4) the relative amount of adipose tissue within the muscle decreased more markedly in the "positive" outcome group. The authors propose that both inactivity and axonal injury (mainly of neurapraxia type) contribute to the selective type 2 atrophy and inner structure changes in disc patients' multifidus muscle. These pathologic structural changes correlated well with the clinical outcome, and most importantly they are reversible and can be diminished by adequate therapy.

Adult↗
PubMed2000

Histochemistry and morphology of the multifidus muscle in lumbar disc herniation: comparative study between diseased and normal sides.

STUDY DESIGN: This comparative study was conducted on 19 patients (13 men and 6 women) with lumbar disc herniation (LDH). The histologic and histochemical differences and changes in the back muscles of the diseased and normal sides were evaluated. OBJECTIVES: To determine the histologic differences in the back muscles between the diseased and normal sides in lumbar disc herniation. SUMMARY OF BACKGROUND DATA: The morphologic changes of back muscles between the diseased and normal sides in lumbar disc herniation were examined using histologic and histochemical methods. Few studies have reported the difference in these changes based on quantitative analyses. METHODS: All samples were harvested bilaterally from the multifidus muscle at the level of L4-L5 or L5-S1 in patients with lumbar disc herniation and then were examined by histologic and histochemical methods (hematoxylin-eosin, Gomori trichrome, NADH-TR, and ATPase stains). The percentage, cross-sectional area (CSA), and lesser diameter (LD) of muscle fibers were measured using computerized image analysis. The Wilcoxon, paired t, Kruskal Wallis, and Fisher tests were used for statistical analysis. RESULTS: Both Type I and II fibers in the diseased side were significantly smaller than those from the normal side. In the diseased side, the potential strength of Type II fibers was weakened. Some pathologic changes (fiber type grouping, small angulated fibers, group atrophy, moth-eaten appearance, and internal nuclei, etc.) in the diseased side were more obvious than those in the normal side. When the straight leg raising test results were abnormal, both Type I and II fibers in the diseased side were smaller than those in the normal side. The Type I fibers of the diseased side were significantly smaller when the patients had symptoms of central low back pain. The size of the Type I fibers as well as of the Type II fibers did not differ between the diseased and normal sides in patients with unilateral and bilateral low back pain. CONCLUSIONS: The present study indicated that there were differences in the characteristics of the multifidus muscle between the diseased and normal sides in patients with lumbar disc herniation. The changes in muscle characteristics primarily were related to the disc protrusion. In addition, different locations of the low back pain seemed to cause different secondary effects on the muscle characteristics.

Adult↗
PubMed2000

Muscle fiber type distribution in multifidus muscle in cases of lumbar disc herniation.

A study was conducted to analyze the distribution and diameter of muscle fiber types in samples of the medial paravertebral lumbar muscle, i.e., multifidus muscle, obtained from 76 patients who underwent surgery for disc herniation. The samples were compared with 41 control samples of corresponding muscle tissue taken from 41 young healthy subjects who had died a sudden death. Histochemical analysis of fibers associated with myofibrillar adenosine triphosphatase (ATPase) revealed the presence of Type I fibers (slow-twitch fibers) and of Type IIA and IIB fibers (fast-twitch fibers) in both the experimental and control samples. The respective percentage of muscle fibers was calculated and their diameters were measured. Type I fibers predominated in both groups and were significantly larger in diameter than Type IIA and IIB fibers. Both fast-twitch fiber types were distributed in almost equal proportions in the healthy women. In the healthy men, Type IIA fibers prevailed. In the healthy females, the percentage of Type I fibers was found to be slightly higher than in the males, but the diameter of all fiber types was respectively smaller. In the females who had undergone surgery, Type I fibers were significantly larger in diameter than those of the healthy subjects. On the other hand, the diameters of all muscle fiber types were significantly larger, and the percentage of both fast-twitch fibers were Idwer in the samples from men who underwent surgery, as compared to the healthy tissue samples. The morphometric changes in the multifidus muscle at the level of the protruded disc observed by the histochemical method for demonstration of myofibrillar ATPase could not be related to the compressed nerve root in the majority of cases in our study.

Adult↗
PubMed1975

Myosin ATPase activity in multifidus muscle from cases of lumbar spinal derangement.

Biopsies of lumbar multifidus muscles were obtained at operation on seventeen patients aged from fifteen to fifty-eight with lumbar spinal derangement, and further material was taken from the cadavers of three subjects aged from nineteen to fifty-one. Sections were prepared to show the presence of ATPase activity, so distinguishing Fast from Slow types of muscle fibre. The normal mosiac pattern arising from the intermingling of fibres from Fast and Slow motor units was seen in sections from cadaveric material and from many of the biopsies. With age and limited lumbar flexibility, the Fast fibres became relatively smaller but with increasing variation in size, suggesting a reduced capacity for phasic activity. The presence of positive root signs was associated with a greater proportion of Slow fibres, and in some patients with the occurrence of atrophied Fast fibres, giving rise to differences in the populations of the two fibres in neighbouring fascicles. The results suggest that multifidus adopts an increasingly postural role with advancing age and with disabling lesions of the lumbar spine.

Adenosine Triphosphatases↗
PubMed1991

Muscle fibre directions of iliocostalis and multifidus: male-female differences.

The accuracy with which the fibre direction of the multifidus muscle can be predicted in females is comparable to that for males, and is well within the limits of accuracy obtainable in the placement of surface electrodes in relation to a reference line drawn on the skin, i.e. +/- 5 degrees. In females, the observed deviation of the iliocostalis fibres from the corresponding reference line may, however, add some degree of error to the proper orientation of electrode bars perpendicular to muscle fibres. It may thus be concluded that the surface recording of EMG power spectrum parameters of the iliocostalis in women cannot be carried out as accurately as for the multifidus muscle. Nevertheless, the resulting recording error associated with a possible orientation deviation of, for example, 13 degrees is rather small (3%) and may be acceptable for clinical research purposes.

Aged↗
PubMed1993

MR relaxation times and fiber type predominance of the psoas and multifidus muscle. An autopsy study.

MR relaxation times, fiber composition, nonmyofiber space, water content, and fat content of human psoas and multifidus muscle samples of 10 male cadavers were studied in vitro. The T1 and T2 relaxation times of multifidus muscle were significantly longer than those of the psoas muscle. On average, type 1 fibers (slow fibers with a small cross-sectional diameter) predominated in both muscles. There was no correlation between the relative mass of type 1 or 2 fibers (fast fibers with a large cross-sectional diameter) or nonmyofiber space and the relaxation times. The quantity of fat in the muscle did not correlate with the relaxation times either.

Adolescent↗
PubMed2004

Simultaneous measurement of intramuscular pressure and surface electromyography of the multifidus muscle.

The anatomic proof of a spinal compartment and the clinical symptoms of compartment syndrome in patients with chronic back pain are inconsistent with the rarely met measuring criteria of intramuscular pressure (IMP). Previous studies assume a dependence of the IMP on spinal alignment (degree of lumbar spine flexion) and the degree of muscle activation. The significance of these disturbance variables in the interpretation of IMP could explain the above discrepancy. This study therefore investigates the influence of both a 30% increase in trunk flexion and alterations in muscle contraction from 100% to 60%. Sixteen healthy subjects participated in the study. The IMP and mean rectified amplitude of the multifidus surface EMG signal were determined at rest and 0 degrees and approximately 30 degrees of lumbar spine flexion, and they were compared. Subsequently, both parameters were measured during both 100% and 60% maximal voluntary contraction (MVC) of the muscle and then correlated. During rest and 0 degrees flexion, the median IMP was 9.3 mmHg (range 0.0-22.5) while the median mean rectified amplitude (MRA) of the EMG signal was 1.98 microV (range 1.32-7.38). In 30 degrees flexion, the median IMP went up to 24.3 mmHg (range 1.4-97.3) with hardly any increase in the median MRA of 2.32 microV (range 1.20-9.72). Under 60% MVC, the median IMP rose to 186.6 mmHg (range 15.4-375.4) and the median MRA to 21.02 microV (range 4.63-43.63). During 100% MVC, the median MRA increased to 34.38 microV (range 12.99-102.54) while the median IMP rose to 273.4 mmHg (range 90.4-395.1). Spearman's rank correlation coefficient for the IMP and MRA quotients of the 100/60% MVC values was r= -0.21. To sum up, it can be said that IMP was subject to great interindividual variation in all the experiments. This parameter is highly dependent on spinal alignment and muscular activity. Further studies are needed so that the IMP can be interpreted properly when diagnosing a chronic compartment of the erector spinae muscles.

Adult↗
PubMed2002

Differences in electromyographic activity in the multifidus muscle and the iliocostalis lumborum between healthy subjects and patients with sub-acute and chronic low back pain.

The present study was carried out to examine possible mechanisms of back muscle dysfunction by assessing a stabilising and a torque-producing back muscle, the multifidus (MF) and the iliocostalis lumborum pars thoracis (ICLT), respectively, in order to identify whether back pain patients showed altered recruitment patterns during different types of exercise. In a group of healthy subjects (n=77) and patients with sub-acute (n=24) and chronic (51) low back pain, the normalised electromyographic (EMG) activity of the MF and the ICLT (as a percentage of maximal voluntary contraction) were analysed during coordination, stabilisation and strength exercises. The results showed that, in comparison with the healthy subjects, the chronic low back pain patients displayed significantly lower (P=0.013) EMG activity of the MF during the coordination exercises, indicating that, over the long term, back pain patients have a reduced capacity to voluntarily recruit the MF in order to obtain a neutral lordosis. In contrast, during the stabilisation exercises, no significant differences between patients and controls were found for the normalised EMG activity of the two muscles. These findings indicated that, during low-load exercises, no insufficiencies in back muscle recruitment were evident in either subacute or chronic back pain patients. During the strength exercises, the normalised activity of both back muscles was significantly lower in chronic low back pain patients (P=0.017 and 0.003 for the MF and ICLT, respectively) than in healthy controls. Pain, pain avoidance and deconditioning may have contributed to these lower levels of EMG activity during intensive back muscle contraction. The possible dysfunction of the MF during coordination exercises and the altered activity of both muscles during strength exercises may be of importance in symptom generation, recurrence or maintenance of low back pain.

Acute Disease↗
PubMed1980

An ultrastructural study of multifidus muscle in progressive idiopathic scoliosis. Changes resulting from a sarcolemmal defect at the myotendinous junction.

Biopsies of multifidus muscles were procured from patients with idiopathic scoliosis prior to Harrington rod instrumentation. Specimens from both convex and concave sides at the apex of the curve were examined by light and electron microscopy and compared with normal muscle samples. Abnormalities were detected on the concave aspect of the curve and the most dramatic morphological changes were noted at the myotendinous junction. Here a structural defect in the form of discontinuities in the sarcolemmal membranes of some muscle fibres was accompanied by large numbers of intimately-adhering connective tissue cells. Structural disorganization of the associated tendon occurred in conjunction with increased vascularization and with fatty cell and leukocyte infiltration. Further from the myotendon junction, structural lesions appeared more chronic and non-specific subsequent to the incipient sarcolemmal break in the affected muscle fibres. Hypertrophy, atrophy, centralization of nuclei, and disruption of sarcotubular and myofibrillar elements were noted in some muscle cells. While the aetiology of this disorder is unknown, a supposition is made that the primary change is an inherent weakness and subsequent break in the sarcolemma at the myotendon junction. This site is an important clue to the pathogenesis of this disease since it reflects morphological change in rapidly growing tissue occurring at the time of the rapid adolescent growth spurt leading to progression of the scoliotic curve.

Adolescent↗
PubMed2006

Measurement of lumbar multifidus muscle contraction with rehabilitative ultrasound imaging.

Rehabilitative Ultrasound Imaging (RUSI) has been validated as a noninvasive method to measure activation of selected muscles. The purpose of this study was to determine the relationship between muscle thickness change, as measured by ultrasonography, and electromyography (EMG) activity of the lumbar multifidus (LM) muscle in normal subjects. Bipolar fine wire electrodes were inserted into the LM at the L4 level of five subjects. Simultaneous EMG and RUSI data (muscle thickness) were collected while subjects performed increasingly demanding postural response tasks thought to activate the LM muscle. To determine the relationship between muscle thickness change and EMG activity, the normalized EMG data were correlated to normalized RUSI data. To determine if the tasks increased the demand on the LM, the mean EMG data were compared over each of the four tasks. Muscle thickness change as measured by RUSI was highly correlated with EMG activity of LM in asymptomatic subjects (r=.79,P<.001). Mean EMG data showed increasing levels of activation across tasks (19-34% of maximum voluntary isometric contraction (MVIC)). The results of the repeated measures ANOVA demonstrated theses differences were significant (F(3,12)=25.39,P<.001). Measurement of muscle thickness change utilizing RUSI is a valid and potentially useful method to measure activation of the LM muscle in a narrow range (19-34% of MVIC) in an asymptomatic population.

Adult↗
PubMed2000

Correlation between the MRI changes in the lumbar multifidus muscles and leg pain.

AIM: In the assessment of the lumbar spine by magnetic resonance imaging (MRI), changes in the paraspinal muscles are frequently overlooked. In this study, our objective was to investigate the relationships between lumbar multifidus (MF) muscle atrophy and low back pain (LBP), leg pain and intevertebral disc degeneration. METHODS: A retrospective study of 78 patients (aged 17-72) with LBP presenting with back pain with or without associated leg pain was undertaken. Their MR images were visually analysed for signs of lumbar MF muscle atrophy, disc degeneration and nerve root compression. The clinical history in each case was obtained from their case notes and pain drawing charts. RESULTS: MF muscle atrophy was present in 80% of the patients with LBP. The correlation between MF muscle atrophy and leg pain was found to be significant (P < 0.01). However, the relationships between muscle atrophy and radiculopathy symptoms, nerve root compression, herniated nucleus pulposus and number of degenerated discs were statistically not significant. CONCLUSION: Examination of the paraspinal muscles looking for atrophy of MF muscle should be considered when assessing MR images of lumbar spine. This may explain the referred leg pain in the absence of other MR abnormalities.

Adolescent↗
PubMed1994

SPECT in avulsion injury of the multifidus and rotator muscles of the lumbar region.

A 37-year-old man was investigated for a work-related back injury with plain radiography, CT scan, bone scintigraphy, and SPECT. SPECT was able to demonstrate multiple sites of increased isotope uptake not seen on plain radiographs, CT scan, or planar images. Consequently, the diagnosis of avulsion injury of the multifidus and rotator muscles of the lumbar region was made. SPECT appears to have a role in the specific diagnosis of work-related back injuries.

Adult↗