Posture‐related stiffness mapping of paraspinal muscles
Résumé
The paraspinal compartment acts as a bone–muscle composite beam of the spine. The elastic properties of the
paraspinal muscles play a critical role in spine stabilization. These properties depend on the subjects’ posture, and
they may be drastically altered by low back pain. Supersonic shear wave elastography can be used to provide
quantitative stiffness maps (elastograms), which characterize the elastic properties of the probed tissue. The aim
of this study was to challenge shear wave elastography sensitivity to postural stiffness changes in healthy
paraspinal muscles. The stiffness of the main paraspinal muscles (longissimus, iliocostalis, multifidus) was
measured by shear wave elastography at the lumbosacral level (L3 and S1) for six static postures performed by
volunteers. Passive postures (rest, passive flexion, passive extension) were performed in a first shear wave
elastography session, and active postures (upright, bending forward, bending backward) with rest posture for
reference were performed in a second session. Measurements were repeated three times for each posture. Sixteen
healthy young adults were enrolled in the study. Non-parametric paired tests, multiple analyses of covariance, and
intra-class correlations were implemented for analysis. Shear wave elastography showed good to excellent
reliability, except in the multifidus at S1, during bending forward, and in the multifidus at L3, during bending
backward. Yet, during bending forward, only poor quality was recorded for nine volunteers in the longissimus.
Significant intra- and inter-muscular changes were observed with posture. Stiffness significantly increased for the
upright position and bending forward with respect to the reference values recorded in passive postures. In
conclusion, shear wave elastography allows reliable assessment of the stiffness of the paraspinal muscles except in
the multifidus at S1 and longissimus, during bending forward, and in the multifidus at L3, during bending
backward. It reveals a different biomechanical behaviour for the multifidus, the longissimus, and the iliocostalis.