Correlation Between LIV, Goutallier Classification And Lumbar Degenerative Changes In Patients With Lumbar Disc Herniation

Objective:The purpose of this study was to evaluate the correlation between LIV(the minimum distance from the apex of the spinous process to the apex of bilateral lumbar back muscles),Goutallier classification,and lumbar degenerative changes in patients with lumbar disc herniation.Background of the research :The cross-sectional area of muscles and the ratio of fat infiltration are used as standard quantitative and qualitative indicators to assess the degree of degeneration of paraspinal muscles,however,using them takes more time.Previous studies have shown that LIV is significantly related to the cross-sectional area of muscles,Goutallier classification is significantly related to the ratio of muscle fat infiltration.At present,only a few studies have evaluated the correlation between two simple indicators(LIV,Goutallier classification)and lumbar degenerative changes in patients with lumbar disc herniation on supine 3.0T MRI.Method:We retrospectively analyzed 3.0T lumbar magnetic resonance images of 100 patients in our hospital,and divided them into lumbar disc herniation group(experimental group)and non-lumbar disc herniation group(control group).There were 50 patients in the experimental group and 50 patients the control group.The determination and evaluation of LIV,Goutallier classification,the degree of degeneration of the intervertebral disc,and the degree of degeneration of the articular processes were independently performed by two orthopedic surgeons using 3.0T supine MRI.Spearman rank correlation test was used to evaluate the correlation between the LIV,Goutallier classification and the degree of disc degeneration,and the degree of joint degeneration in the lumbar disc herniation group.The Mann-Whitney U test was used to evaluate the difference of LIV and Goutallier classification between the lumbar disc herniation group and the non-lumbar disc herniation group.Result:In the disc herniation group,Goutallier classification and intervertebral disc degeneration(Spearman’s rho coefficient= 0.61,p < 0.01)and facet joints degeneration(Spearman’s rho coefficient = 0.753,p < 0.01)showed significant positive correlation,LIV and the intervertebral disc degeneration(Spearman’s rho coefficient =-0.504,p<0.01)and the facet joints degeneration(Spearman’s rho coefficient =-0.347,p<0.05)showed negative correlation;LIV was significantly different between the experimental group and the control group(p <0.01),but the Goutallier grade was not significantly different between the two groups(p> 0.05).Conclusion:There is a specific correlation between lumbar paraspinal muscle quantity(LIV)and quality(Goutallier classification)and lumbar degenerative changes.These two simple indicators can be used to assess the correlation between paraspinal muscle degeneration and lumbar degenerative changes in clinical work,which can help clinicians to guide patients to perform back muscle function exercises,it can relieve the pain and improve lumbar vertebral curvature and lumbar dysfunction.