Objective To study the relationship between the changes of erector spinae and multifidus in supine and prone flexion and lumbar disc herniation(LDH).Methods 21 patients with lumbar disc herniation(herniation group)and 21 healthy volunteers(control group)were selected from the 903 Hospital of the Chinese People's Liberation Army.Both groups underwent supine and prone flexion L3-S1 segment disc scanning.Image J software was used to measure the data of erector spinae(ES)and multifidus(MF)on axial T2 WI images in two positions.The measurement parameters were as follows:total cross-sectional area(TCSA),fat infiltration ratio(FIR),functional cross-sectional area(FCSA),asymmetry of cross-sectional area on both sides(TCSAasy,FCSAasy)and the difference between TCSA,FCSA and FIR(S-P)were calculat-ed.Paired sample t test was used to compare the parameters between supine position and prone flexion position.Independ-ent sample t test or Mann-Whitney U test was used to compare the parameters between the two groups.ROC curve was used to evaluate the efficacy of ES and MF changes in LDH.P<0.05 was considered statistically significant.Results In the control group and the protrusion group,the TCSA and FCSA of ES and MF in each segment of L3-S1 in supine position were higher than those in prone position(P≤0.001).The FIR of L3/4 segment ES,L3-5 segment MF in the control group and L3/4 segment MF in the protrusion group increased in prone position compared with supine position(P<0.05).TCSA of L5/S1 segment control group ES and MF of protrusion group,FCSA of L3/4 segment control group MF were bilateral asymme-try(P<0.05).There was no significant difference in the other segmental parameters of TCSAasy,FCSAasy and FIR between the two groups(P>0.05).TCSA and FCSA of ES at L3/4 segment in prone position were asymmetric between two groups(P<0.05).The S-PTCSA of MF and S-PFCSA of L3-5 segments in the L3-S1 segment herniation group were lower than those in the control group(P<0.05).There was no significant difference in ES and MF parameters between the other segments(P>0.05).ROC curve showed that MF(AUC =0.920)was superior to ES(AUC =0.814)for LDH,S-PTCSA(AUC =0.925)was the highest,S-PFCSA(AUC =0.805)was the second,and the other parameters of MF and parameters of ES were general for LDH.Conclusion MRI examination in supine and prone flexion position showed that the erector spinae and multifidus played an important role in maintaining the normal physiological curvature of lumbar spine.There was no correlation be-tween ES degeneration and LDH.Multifidus degeneration was one of causes of LDH,which was of great significance to stud-y the causes and pathogenesis of lumbar disc herniation.
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