Abstract
BackgroundThe paraspinal and psoas muscles have been considered to be essentially important for stabilizing the spinal column, and the muscle degeneration was found to exist in degenerative spinal kyphosis (DSK) patients. However, it is still not clear the relationship between muscle degeneration and spinal-pelvic alignment. The purpose of this study was to determine the correlations between the individual muscle degeneration at each lumbar spinal level and spinal-pelvic parameters in DSK patients.MethodsThe imaging data of 32 patients with DSK were retrospectively analyzed. The fat infiltration (FI) and relative cross-sectional area of muscle (RCSA) were quantitatively measured for multifidus (MF), erector spinae (ES) and psoas (PS) at each spinal level from L1/2 to L5/S1. The correlations were analyzed between RCSA and the sagittal vertical axis (SVA), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI).ResultsThe FI of MF and ES at L3/4, L4/5 and L5/S1 were higher than that at L1/2 and L2/3. The FI of PS at L4/5 and L5/S1 were lower than that of L1/2, L2/3 and L3/4. The RCSA of ES and PS from L1/2 to L5/S1 gradually increased, whereas the RCSA of ES from L1/2 to S5/S1 gradually decreased. The RCSA of MF at the L1/2 level was negatively correlated SVA (r = − 0.397,p = 0.024); the RCSA at L3/4, L4/5 and L5/S1 levels were negatively correlated with TK (r = − 0.364, p = 0.04; r = − 0.38, p = 0.032; r = − 0.432, p = 0.014); the RCSA at L4/5 level was positively correlated with LL (r = 0.528, p = 0.002). The RCSA of ES at L3/4 and L4/5 levels were positively correlated with PI (r = 0.377, p = 0.037) and SS (r = 0.420, p = 0.019).ConclusionsFI of MF and ES at lower lumbar level is higher than that at upper level, but FI of PS at upper lumbar level is higher than that at lower level. MF and ES have different roles for maintaining the sagittal spinal-pelvic balance.
Highlights
The paraspinal and psoas muscles have been considered to be essentially important for stabilizing the spinal column, and the muscle degeneration was found to exist in degenerative spinal kyphosis (DSK) patients
Degenerative spinal kyphosis (DSK) is the structural deformity caused by spinal degeneration, which is mainly manifested by the decrease or loss of normal lordosis angle of the lumbar part of the spine or increased kyphosis of the thoracic or thoracolumbar part on the sagittal plane [1]
Previous studies used average fat infiltration (FI), cross-sectional area (CSA) or relative cross-sectional area of muscle (RCSA) from L1/2 to L5/S1 for comparing the individual muscle degeneration between groups, it is still unclear how they change from L1/2 to L5/S1 for individual muscle and whether they are different between muscles at the same spinal level
Summary
The paraspinal and psoas muscles have been considered to be essentially important for stabilizing the spinal column, and the muscle degeneration was found to exist in degenerative spinal kyphosis (DSK) patients. The paraspinal muscles show asymmetry in patients with degenerative scoliosis, i.e., the cross-sectional area (CSA) of the multifidus muscle was significantly smaller, and the percentage of fat infiltration of both the multifidus and longissimus muscles was significantly higher on the concave side of the curve at all spinal levels [8]. This indicates that the different extent of back muscles degeneration could be accompanied with different extent of spinal deformity. The individual measurements of each muscle, including multifidus, erector spinae and psoas, should have great value for showing their specific degenerative characteristics and roles affecting spinal sagittal alignment in DSK patients
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call