Lumbar magnetic resonance imaging hypolordosis in symptomatic patients: association with paraspinal muscle spasms

Gilbert, John W.; Wheeler, Greg R.; Storey, Benjamin B.; Mick, Gregory E.; Herder, Stephanie L.; Richardson, Gay; Wyttenbach, William H.; Martin, J. Chad

doi:10.1016/j.jcm.2009.05.001

« Previous Next »Journal of Chiropractic Medicine
Volume 8, Issue 3 , Pages 95-100, September 2009

Lumbar magnetic resonance imaging hypolordosis in symptomatic patients: association with paraspinal muscle spasms☆

John W. Gilbert, MD
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
- Corresponding author. Spine and Brain Neurosurgical Center, 1721 Nicholasville Rd, Lexington, KY 40503, USA. Tel.: +1 859 252 6500; fax: +1 859 252 3073.
Greg R. Wheeler, MD
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
Benjamin B. Storey, MD
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
Gregory E. Mick, DO
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
Stephanie L. Herder, MD
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
Gay Richardson, MD
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
William H. Wyttenbach, MD
- Spine and Brain Neurosurgical Center, Lexington, KY 40503
J. Chad Martin, DC
- Pikeville College, School of Osteopathic Medicine, Pikeville, KY 41501

Received 3 February 2009; received in revised form 1 May 2009; accepted 10 May 2009.

Abstract

Objective

This study examined a set of patients who were symptomatic for low back pain and who had significant lumbar hypolordosis as assessed by visual evaluation of magnetic resonance images to investigate the frequency of comorbid paraspinal muscle spasms as determined via history or physical examination.

Methods

A retrospective chart review was performed on 50 patients who had significant hypolordosis on magnetic resonance imaging (MRI) (Cobb angle <20°) to determine whether they were positive for paraspinal muscle spasms by either history or physical examination.

Results

Of the 50 patients with significant hypolordosis on MRI, 66% (33) had a history of paraspinal muscle spasms, 76% (38) had a positive physical examination for palpation of paraspinal muscle spasms, and 48% (24) were positive for both history and physical examination.

Conclusions

This retrospective study suggests that most symptomatic patients with significant hypolordosis on lumbar MRI have a positive history or physical examination for paraspinal muscle spasm. Thus, MRI finding of significant hypolordosis (Cobb angle <20°) could potentially be a valuable tool in addition to medical history and physical examination in aiding clinicians in diagnosing paraspinal muscle spasms in symptomatic patients and in helping them to formulate appropriate and effective treatments.

Key indexing terms: Lordosis, Spinal curvatures, Spinal diseases, Magnetic resonance imaging, Spasm