Feasibility assessment of shear wave elastography to lumbar back muscles: A radioanatomic study

ABSTRACT

Introduction: Low back pain is often associated with tensional changes in the paraspinal muscles detected by palpatory procedures. Shear wave elastography (SWE), recently introduced, allows the stiffness of muscles to be assessed non-invasively. The aim of our work was to study the feasibility of using SWE on the three main lumbar back muscles (multifidus, longissimus and iliocostalis) in vivo after analyzing their muscular architecture ex vivo.

Materials and methods: We determined the orientation of fibers in the multifidus, longissimus and iliocotalis muscles in seven fresh cadavers using gross anatomy and B-Mode ultrasound imaging. We then quantified the stiffness of these three muscles at the L3 level ex vivo and in 16 healthy young adults.

Results: Little pennation was observed in the longissimus and iliocostalis, in which the direction of fibers was almost parallel to the line of spinous processes. The multifidus appeared as a multiceps and multipennate muscle. Given the random layering of millimetric fascicles, tendons and fatty spaces, the multifidus had multiple fiber orientations. Muscular fascicles and fibers were oriented from 9° to 22° to the line of spinous processes. The shear moduli related to stiffness were 6.9±2.7 kPa for the longissimus, 4.9±1.4 kPa for the iliocostalis and 5.4±1.6 kPa for the multifidus.

Conclusion: SWE is a feasible method for quantifying the stiffness of the lumbar back muscles. This article is protected by copyright. All rights reserved.

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