Abstract
ObjectiveThis study aimed to establish sex- and age-dependent distributions of the cross sectional area and fatty infiltration ratio of paraspinal muscles, and to examine the correlation between paraspinal muscle degeneration and low back pain in the Japanese population.MethodsIn this cross-sectional study, data from 796 participants (241 men, 555 women; mean age, 63.5 years) were analyzed. The measurement of the cross sectional area and fatty infiltration ratio of the erector spinae and multifidus from the level of T12/L1 to L4/5 and psoas major at the level of T12/L1 was performed using axial T2-weighted magnetic resonance imaging. Multivariate logistic regression analysis was used to estimate the association between fatty infiltration of the paraspinal muscles and the prevalence of low back pain.ResultsThe cross sectional area was larger in men than women, and tended to decrease with age, with the exception of the erector spinae at T12/L1 and L1/2 in women. The fatty infiltration ratio was lower in men than women, except for multifidus at T12/L1 in 70–79 year-olds and psoas major in those less than 50 years-old, and tended to increase with age. Logistic regression analysis adjusted for age, sex, and body mass index showed that the fatty infiltration ratio of the erector spinae at L1/2 and L2/3 was significantly associated with low back pain (L1/2 level: odds ratio, 1.05; 95% confidence interval, 1.005–1.104; L2/3 level: odds ratio, 1.05; 95% confidence interval, 1.001–1.113).ConclusionThis study measured the cross sectional area and fatty infiltration ratio of paraspinal muscles in the Japanese population using magnetic resonance imaging, and demonstrated that the fatty infiltration ratio of the erector spinae in the upper lumbar spine was significantly associated with the presence of low back pain. The measurements could be used as reference values, which are important for future comparative studies.
Highlights
Sarcopenia, which is characterized by the loss of muscle mass and strength associated with aging, is a common problem in elderly societies [1,2,3,4]
The cross sectional area was larger in men than women, and tended to decrease with age, with the exception of the erector spinae at T12/L1 and L1/2 in women
Logistic regression analysis adjusted for age, sex, and body mass index showed that the fatty infiltration ratio of the erector spinae at L1/2 and L2/3 was significantly associated with low back
Summary
Sarcopenia, which is characterized by the loss of muscle mass and strength associated with aging, is a common problem in elderly societies [1,2,3,4]. Sarcopenia is common and believed to play a major role in the pathogenesis of frailty in the aging population [1,5]. Some studies reported age-related morphologic changes of the lumbar paravertebral muscles and the association between degeneration of the paraspinal muscles and LBP using MRI, but these studies included patients or volunteers, suggesting selection bias [9, 11,12,13]. To the best of our knowledge, no research to date has assessed age-related degeneration of paravertebral muscles in the general population
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