Spinecare Topics
Types of Spinal Injury
Normal joint mobility is essential for smooth function of the interconnected spinal segments. The neurological control of muscle activity around the spine is influenced by the quality of joint mobility. The health and integrity of intervertebral disks and the cartilage of the facet joints are dependent upon on spinal segment movement for the optimum delivery of nutrients and removal of waste products.
Some of the degenerative changes associated with immobilization are reversible with therapeutic remobilization.
What Can Go Wrong with the Muscles of the Spine?
Lack of Use (Disuse Atrophy): When muscles are not used muscle fibers shrink in volume/size. This process is referred to as muscle atrophy. A loss of spinal segment movement may result in muscle atrophy, including atrophy of the deep muscles around the spinal segment. Degenerative disc disease and the loss of disc volume contributes to muscle shortening within the involved spinal segment. Back pain leads to restricted movement. Disuse muscle atrophy usually results in earlier and greater degree of atrophy of fast-twitch type 2 muscle fibers. Regular exercise of the spine muscles can prevent as well reverse muscle atrophy. Pain and reflex inhibition of muscle can also cause weakness and muscle atrophy. Muscle atrophy along the spine has been revealed in individuals with chronic low back pain even after spinal surgery.
Loss of Nerve Supply To Muscle: A loss of nerve connection to muscles of the extremity and back results in muscle atrophy and weakness. This is called denervation atrophy. Denervation muscle atrophy results in compromise of all muscle fibers belonging to a compromised nerve. The loss of nerve supply to the deep spinal muscles results in atrophy and altered muscular control and stability of the involved spinal region. Denervation muscle atrophy can occur secondary to inflammation and/or compression of a spinal nerve root. Compromise of a spinal nerve root can result in atrophy of deep spinal muscles including the multifidus muscle. This is sometimes characterized on MRI by a loss of muscle fiber density and increased fat signal. Loss of nerve supply to deep spinal muscles usually results in damage to type I and type II muscle fibers.
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