Morphological differences in the psoas major muscle and influencing factors for pain severity in patients with different types of lumbar disc herniation: an analysis based on quantitative computed tomography
10.13491/j.issn.1004-714X.2026.02.012
- VernacularTitle:基于定量CT评估不同类型腰椎间盘突出症患者腰大肌形态差异及疼痛程度影响因素分析
- Author:
Hongjie WANG
1
;
Zhigang CHEN
1
;
Pengfei GUO
1
;
Qinghua ZHAO
2
Author Information
1. Department of Spinal Surgery, Hai'an People's Hospital, Hai'an 226600, China.
2. Department of Spinal Surgery, Shanghai General Hospital, Shanghai 201600, China.
- Publication Type:OriginalArticles
- Keywords:
Lumbar disc herniation;
Computed tomography;
Psoas major muscle morphology;
Pain
- From:
Chinese Journal of Radiological Health
2026;35(2):235-239
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the difference of psoas major muscle morphology and pain degree in patients with different types of lumbar disc herniation ( LDH ) by quantitative CT, and to further explore the relationship between psoas major muscle morphology and pain degree. Methods A total of 120 patients with LDH admitted to our hospital from January to December 2025 were enrolled as study subjects. Based on clinical symptoms and lesion location, they were divided into a simple lower extremity pain group and a lumbar and leg pain group. All patients underwent lumbar CT examination. The psoas major muscle index was used as a CT quantitative parameter, which was calculated as the mean of the maximum cross-sectional areas of both psoas major muscles divided by the cross-sectional area of the L5 vertebral body. This index was measured to reflect psoas major muscle morphology. Pain severity was assessed using the visual analogue scale (VAS). Differences in psoas major muscle morphology and pain severity between the two groups were compared. A Pearson correlation analysis was used to examine the relationship between the psoas major muscle index and pain severity. A linear regression model was used to analyze the independent risk factors affecting pain severity. Results There were no statistically significant differences in sex, age, or body mass index between the two groups (P>0.05). The disease duration was longer and the incidence of anxiety and depression was higher in the lumbar and leg pain group than those in the simple lower extremity pain group (P<0.05). Compared with the simple lower extremity pain group, the lumbar and leg pain group showed lower psoas major muscle index [(0.53 ± 0.05) vs. (0.61 ± 0.07)] and higher VAS score [(4.67 ± 1.10) vs. (3.02 ± 0.89)], and the differences were statistically significant (P<0.05). Pearson correlation analysis revealed a negative correlation between the psoas major muscle index and the VAS score (r=−0.288, P<0.05). Linear regression model analysis indicated that the independent risk factors affecting the VAS score were age, disease duration, LDH type, and the psoas major muscle index. Conclusion Compared with LDH patients with simple lower extremity pain, those with lumbar and leg pain demonstrate a longer disease duration, a higher incidence of anxiety and depression, and a higher severity of psoas major muscle atrophy and pain. The severity of pain is associated with not only advanced age and prolonged disease duration but also the LDH type and psoas major muscle atrophy.
