Dynamic Ultrasound Quantification of Acupuncture-Induced Multifidus Recovery in Lumbar Disc Herniation

To validate musculoskeletal ultrasound for quantifying real-time morphological changes in multifidus muscles during acupuncture treatment of lumbar disc herniation (LDH).

Sixty LDH patients received Qi-needling at BL40. Morphological parameters (cross-sectional area [CSA], multifidus muscle thickness [MMT], muscle activation rate [MAR]) were assessed via ultrasound in resting/shrinkage states. Clinical outcomes included Visual Analog Scale (VAS), Japanese Orthopaedic Association (JOA) scores, and infrared thermography of lumbar temperature.

Quantitative ultrasound revealed significant post-acupuncture improvements in multifidus morphology: After acupuncture, CSA at resting-state increased to 251.88mm² from 190.66mm², and to 305.28mm² from 219.22mm² at shrinkage-state, and MMT at resting-state increased to 11.50mm from 9.15mm, and to 14.04mm from 10.77mm at shrinkage-state. Both results show a significant increase compared to the initial state (P<0.05). While MAR increased from 18.28% to 22.79% with a statistically significant difference (P<0.05). Clinically, VAS scores significantly decreased after treatment, dropping from 6.35 to 1.15, while JOA scores increased from 11.77 to 20.62 (P<0.05). Infrared thermography detected a 1.23°C rise in lumbar temperature (31.09 ± 0.95°C to 32.32 ± 0.85°C, P < 0.05).

Musculoskeletal ultrasound provides objective, dynamic biomarkers for evaluating acupuncture-induced multifidus recovery, enabling precision rehabilitation in LDH.