Lumbar medial branch radiofrequency neurotomy (RFN), a common treatment for chronic low back pain due to facet joint osteoarthritis (FJOA), may amplify paraspinal muscle atrophy due to denervation. This study aimed to investigate the asymmetry of paraspinal muscle morphology change in patients undergoing unilateral lumbar medial branch RFN. Data from patients who underwent RFN between March 2016 and October 2021 were retrospectively analyzed. Lumbar foramina stenosis (LFS), FJOA, and fatty infiltration (FI) functional cross-sectional area (fCSA) of the paraspinal muscles were assessed on preinterventional and minimum 2-year postinterventional MRI. Wilcoxon signed-rank tests compared measurements between sides. A total of 51 levels of 24 patients were included in the analysis, with 102 sides compared. Baseline MRI measurements did not differ significantly between the RFN side and the contralateral side. The RFN side had a higher increase in multifidus FI (+4.2% [0.3-7.8] vs +2.0% [-2.2 to 6.2], P = 0.005) and a higher decrease in multifidus fCSA (-60.9 mm2 [-116.0 to 10.8] vs -19.6 mm2 [-80.3 to 44.8], P = 0.003) compared with the contralateral side. The change in erector spinae FI and fCSA did not differ between sides. The RFN side had a higher increase in multifidus muscle atrophy compared with the contralateral side. The absence of significant preinterventional degenerative asymmetry and the specificity of the effect to the multifidus muscle suggest a link to RFN. These findings highlight the importance of considering the long-term effects of lumbar medial branch RFN on paraspinal muscle health.

中文翻译：

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接受单侧腰椎内侧支射频神经切断术的患者出现椎旁肌不对称萎缩。

腰椎内侧支射频神经切断术 (RFN) 是治疗小关节骨关节炎 (FJOA) 引起的慢性腰痛的常见方法，可能会加剧去神经支配引起的椎旁肌肉萎缩。本研究旨在探讨接受单侧腰椎内侧支 RFN 的患者椎旁肌肉形态变化的不对称性。对 2016 年 3 月至 2021 年 10 月期间接受 RFN 的患者数据进行回顾性分析。通过介入前和介入后至少 2 年的 MRI 评估腰椎孔狭窄 (LFS)、FJOA 和椎旁肌脂肪浸润 (FI) 功能横截面积 (fCSA)。 Wilcoxon 符号秩检验比较了双方之间的测量结果。分析共纳入24名患者的51个水平，比较102侧。 RFN 侧和对侧之间的基线 MRI 测量结果没有显着差异。 RFN 侧的多裂肌 FI 增加较多（+4.2% [0.3-7.8] vs +2.0% [-2.2 至 6.2]，P = 0.005），多裂肌 fCSA 减少较多（-60.9 mm2 [-116.0 至 10.8] ] vs -19.6 mm2 [-80.3 至 44.8]，P = 0.003) 与对侧相比。竖脊肌 FI 和 fCSA 的变化在两侧之间没有差异。与对侧相比，RFN 侧的多裂肌萎缩增加较多。介入前不存在显着的退行性不对称性，并且对多裂肌的影响具有特异性，表明与 RFN 存在关联。这些发现强调了考虑腰椎内侧支 RFN 对椎旁肌肉健康的长期影响的重要性。