Objectives To observe the morphological changes of paraspinal muscles on both sides of lumbar degenerative patients, and to analyze its clinical significance. Methods A retrospective analysis of 84 patients with lumbar degenerative lumbar stenosis who were hospitalized from January 2015 to December 2017 in our hospital was performed. The patients were divided into the following three groups: group A: the parietal vertebra was located at the L2-3 intervertebral disc, group B: the parietal vertebra was located at the L3 vertebral body, and group C: the parietal vertebra was located at the L3-4 intervertebral disc. The data of paraspinal muscles were measured by image pro PLus software. Results (1) In group A, the area of the multifissure muscle (MF) in the apical vertebra segment was larger than that in the concave side. The degree of MF fat infiltration in the convex side was smaller than that in the concave side. (2) The area ratio of the psoas major muscle (PS) in the convex side was smaller than that in the concave side, and the fat infiltration degree. (3) Groups A, B and C had similar results on the upper and next intervertebral disc plane of the parietal vertebra. Conclusions In patients with degenerative scoliosis, the degree of muscle degeneration in the convex and concave side is different, the concave side is larger than the convex side, and the degenerative segment mainly occurs in the upper and lower segments of the parietal vertebra. Muscle degeneration is mainly caused by the increasing of fat infiltration of muscle.
Yang Bin, Zheng Minghui, Ling Duhua, Chen Weidong, Qu Dongbin
. Morphological changes of paravertebral muscles in patients with lumbar degenerative scoliosis[J]. Chinese Journal of Clinical Anatomy, 2021
, 39(3)
: 263
-268
.
DOI: 10.13418/j.issn.1001-165x.2021.03.004
[1] Benner B, Ehni G. Degenerative lumbar scoliosis[J]. Spine (Phila Pa 1976),1979,4(6):548-552.
[2] Aebi M. The adult scoliosis[J]. Eur Spine J, 2005,14(10):925-948. DOI:10.1007/s00586-005-1053-9.
[3] 谢冬晓，丁文元，申勇，等. 退变性腰椎侧凸两侧椎旁肌的影像学差异及其临床意义[J]. 中华外科杂志, 2012, 50(11):975-980. DOI:10.3760/cma.j.issn.0529-5815.2012.11.004.
[4] Parkkola R, Kormano M. Lumbar disc and back muscle degeneration on MRI: correlation to age and body mass[J]. J Spinal Disord,1992, 5(1):86-92. DOI:10.1097/00002517-199203000-00011.
[5] Shahidi B, Parra C L, Berry D B, et al. Contribution of lumbar spine pathology and age to paraspinal muscle size and fatty infiltration[J]. Spine (Phila Pa 1976), 2017, 42(8): 616-623. DOI:10.1097/BRS.0000 000000001848.
[6] Ploumis A, Michailidis N, Christodoulou P, et al. Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease[J]. Br J Radiol, 2011, 84(1004):709-713. DOI:10.1259/bjr/58136533.
[7] Kim H, Lee C, Yeom JS, et al. Asymmetry of the cross-sectional area of paravertebral and psoas muscle in patients with degenerative scoliosis[J]. Eur Spine J, 2013, 22(6):1332-1338. DOI:10.1007/s00586-013-2740-6.
[8] Belavy D L, Armbrecht G, Richardson C A, et al. Muscle atrophy and changes in spinal morphology: is the lumbar spine vulnerable after prolonged bed-rest?[J]. Spine (Phila Pa 1976), 2011, 36(2):137-145. DOI:10.1097/BRS.0b013e3181cc93e8.
[9] Tabaraee E, Ahn J, Bohl DD, et al. Quantification of multifidus atrophy and fatty infiltration following a minimally invasive microdiscectomy[J]. Int J Spine Surg, 2015, 9:25. DOI:10.14444/2025.
[10]Cypress BK. Characteristics of physician visits for back symptoms: a national perspective[J]. Am J Public Health,1983,73(4):389-395. DOI:10.2105/ajph.73.4.389.
[11]Cholewicki J, Mcgill S M. Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain[J]. Clin Biomech (Bristol, Avon), 1996, 11(1):1-15. DOI:10.1016/0268-0033（95）00035-6.
[12]Freeman MD, Woodham MA, Woodham AW. The role of the lumbar multifidus in chronic low back pain: a review[J]. PM R, 2010,2(2):142-146, 167. DOI:10.1016/j.pmrj.2009.11.006.
[13]Hides J, Gilmore C, Stanton W, et al. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects[J]. Man Ther, 2008,13(1): 43-49. DOI:10.1016/j.math.2006.07.017.
[14]Kjaer P, Bendix T, Sorensen J S, et al. Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?[J]. BMC Med, 2007, 5:2. DOI:10.1186/1741-7015-5-2.
[15]Mengiardi B, Schmid M R, Boos N, et al. Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy[J]. Radiology, 2006, 240(3): 786-792. DOI:10.1148/radiol.2403050820.
[16]Eguchi Y, Suzuki M, Yamanaka H, et al. Associations between sarcopenia and degenerative lumbar scoliosis in older women[J]. Scoliosis Spinal Disord,2017,12(1):9. DOI:10.1186/s13013-017-0116-0.
[17]Chon J, Kim H, Lee J H, et al. Asymmetric atrophy of paraspinal muscles in patients with chronic unilateral lumbar radiculopathy[J]. Ann Rehabil Med, 2017, 41(5):801. DOI:10.5535/arm.2017.41.5.801.
[18]Altinkaya N, Cekinmez M. Lumbar multifidus muscle changes in unilateral lumbar disc herniation using magnetic resonance imaging[J]. Skeletal Radiol, 2016, 45(1):73-77. DOI:10.1007/s00256-015-2252-z.
[19]Fortin M, Lazáry À, Varga PP, et al. Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation[J]. Eur Spine J, 2016,25(5):1452-1459. DOI:10.1007/s00586-016-4503-7.
[20]Fortin M, Lazáry À, Varga PP, et al. Association between paraspinal muscle morphology, clinical symptoms and functional status in patients with lumbar spinal stenosis[J]. Eur Spine J,2017, 26(10):2543-2551. DOI:10.1007/s00586-017-5228-y.
[21]Jae-Hyun P, Koh-Woon K, Yousuk Y, et al. Association of MRI-defined lumbar paraspinal muscle mass and slip percentage in degenerative and isthmic spondylolisthesis[J]. Medicine, 2019, 98(49). DOI:10.1097 / MD.0000000000018157.
[22]Dulor J P, Cambon B, Vigneron P, et al. Expression of specific white adipose tissue genes in denervation-induced skeletal muscle fatty degeneration[J]. FEBS Lett,1998,439(1-2):89-92. DOI:10.1016 / s0014-5793（98）01216-2.
[23]Campbell WW, Vasconcelos O, Laine FJ. Focal atrophy of the multifidus muscle in lumbosacral radiculopathy[J]. Muscle Nerve,1998,21(10):1350~1353. DOI:10.1002 /（sici）1097-4598（199810）21:10 <1350: aid-mus21> 3.0.co; 2-4.
