Bel Ağrısı Şikâyeti Olan Hastalarda Psoas Kas Dejenerasyonunun Disk ve Faset Eklem Dejenerasyonu ile İlişkisinin Lomber MRG ile Ortaya Konması

Amaç: Bel ağrısı şikâyeti olan hastalarda lomber Manyetik Rezonans (MR) görüntüleme ile psoas kasının lipoatrofisi ile faset ve disk dejenerasyonu arasındaki ilişkinin belirlenmesidir. Gereç ve Yöntemler: Bu kesitsel çalışmada bel ağrısı bulunan 304 hasta retrospektif olarak incelendi. Bu hastaların lomber MR görüntüleri psoas kasının atrofi bulguları bakımından değerlendirildi. Her bir kas için yağ içeriği, yarı-kantitatif (evre 0-4) olarak derecelendirildi. Her bir hastanın disk ve faset eklem dejenerasyonları derecelendirildi. Psoas kas kalınlıkları vertebraya paralel olacak şekilde medio-lateral aksiyel planda ölçüldü. Bulgular: Hastaların sağ psoas kası kalınlığının ortalama 35.9±7.2 mm, sol psoas kası kalınlığının ortalama 35.8±7.1mm olduğu tespit edilmiştir. Ek olarak sağ psoas kası dejenerasyonunun %41.8’inin grade 1, %41.1’inin grade 2 seviyesinde, sol psoas kası dejenerasyonunun %33.6’sının grade 1, %45.1’inin grade 2 seviyesinde, sağ faset dejenerasyonunun %64.1’inin grade 1, %23.4’ünün grade 2 seviyesinde, sol faset dejenerasyonunun %53.9’unun grade 1, %30.3’ünün grade 2 seviyesinde olduğu görülmüştür. Sonuç: Lomber vertebranın MR görüntülerinin değerlendirilmesinde psoas kasların atrofi bakımından incelenmesi gerekmektedir. Bel ağrısı bulunan hastalarda psoas kasının lipoatrofinin bilinmesi, daha iyi rehabilitasyon planlaması yapılmasında faydalı olabilir.

Anahtar Kelimeler:

Disk, Faset eklem, Bel ağrısı, Manyetik rezonans görüntüleme, Psoas kası

The Evaluation of The Relationship Between Psoas Muscle Atrophy and Intervertebral Disc and Facet Joint Degeneration in Patients With Lumbar Pain Using Lumbar Spine MRI

Objective: The purpose of the present study was to determine the relationship between psoas muscle lipoatrophy and facet and disc degeneration in patients with low back pain with lumbar spinal Magnetic Resonance Imaging (MRI). Material and Methods: A total of 304 patients who had low back pain were included in this retrospective cross-sectional study. The lumbar MRIs of all patients were evaluated for signs of psoas muscle atrophy. Fat content for each muscle was graded semi-quantitatively (Grade 0-4). The disc and facet joint degenerations of each patient were also graded. Psoas muscle thickness was measured in the mediolateral axial plane parallel to the vertebra. Results: It was found that the mean right psoas muscle thickness score of the patients was 35.9±7.2 mm on average, and the mean left psoas muscle thickness score was 35.8±7.1 mm. It was also found that 41.8% of the right psoas muscle degeneration was grade 1, 41.1% was grade 2, 33.6% of the left psoas muscle degeneration was grade 1, 45.1% was grade 2, 64.1% of the right facet degeneration was grade 1, 23.4% was grade 2, and 53.9% of the left facet degeneration was grade 1, and 30.3% was grade 2. Conclusion: When lumbar spine MRI examinations are evaluated, psoas muscles must also be evaluated in terms of atrophy. Indicating psoas muscle lipoatrophy in patients with low back pain may be useful for better rehabilitation planning.

Keywords:

Disc, Facet joint, Low back pain, Magnetic Resonance Imaging, Psoas muscle,

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