Characteristic of Paraspinal Muscle Change in Coronal Sub-type of Degenerative Lumbar Scoliosis and Its Potential Clinical Significance

Overview

Journal Orthop Surg

Specialty Orthopedics

Date 2024 Aug 8

PMID 39117580

Authors

Zhenguo Shang

Hengrui Chang

Jiaxin Xu

Wenyuan Ding

Hui Wang

Di Zhang

Affiliations

Soon will be listed here.

Abstract

Objective: Clarifying paraspinal muscle (PM) change in degenerative lumbar scoliosis (DLS) is positive to evaluate the progression of scoliosis. This research compares the characteristic of PM change among different coronal sub-types of DLS and explores its potential clinical significance.

Methods: A total of 84 DLS patients between June 2019 to December 2021 were retrospectively analyzed. Patients were classified into three types based on the coronal balance distance (CBD): Type A, CBD <3 cm; Type B: C7 Plumb Line (C7PL) shifted to the concave side of the curve, and CBD >3 cm; Type C: C7PL shifted to the convex side of the curve, and CBD >3 cm. Fat infiltration rates in the multifidus (MS) and erector spinae (ES) at the apex of the main and fractional curves, and spinopelvic parameters were analyzed statistically. Pearson's or Spearman's correlation was applied to analyze the correlation between asymmetric degree of PM change and these parameters in three types.

Results: There were 62 cases with coronal sub-Type A, 6 cases with Type B, and 16 cases with Type C. Patients in Type B and C demonstrated higher fat infiltration in MS on the concave side of both the main and fractional curves when compared to those in Type A. The asymmetric degree of ES change was positively correlated with CBD at the apex of the main curve in Type B and at the apex of the fractional curve in Type C respectively, and that of MS was positively correlated with apical vertebral rotation, while negatively strong-correlated with pelvic incidence and sacral slope in Type C.

Conclusion: PM fatty infiltration presented difference among varied coronal sub-types of DLS patients. The CBD in Type B and C patients was correlated with the asymmetric degree of ES change.

References

Jiang J, Meng Y, Jin X, Zhang C, Zhao J, Wang C . Volumetric and Fatty Infiltration Imbalance of Deep Paravertebral Muscles in Adolescent Idiopathic Scoliosis. Med Sci Monit. 2017; 23:2089-2095. PMC: 5424650. DOI: 10.12659/msm.902455. View

Bao H, Yan P, Qiu Y, Liu Z, Zhu F . Coronal imbalance in degenerative lumbar scoliosis: Prevalence and influence on surgical decision-making for spinal osteotomy. Bone Joint J. 2016; 98-B(9):1227-33. DOI: 10.1302/0301-620X.98B9.37273. View

Suzuki K, Hasebe Y, Yamamoto M, Saita K, Ogihara S . Risk Factor Analysis for Fat Infiltration in the Lumbar Paraspinal Muscles in Patients With Lumbar Degenerative Diseases. Geriatr Orthop Surg Rehabil. 2022; 13:21514593211070688. PMC: 8772358. DOI: 10.1177/21514593211070688. View

Macintosh J, Bogduk N . The biomechanics of the lumbar multifidus. Clin Biomech (Bristol). 2013; 1(4):205-13. DOI: 10.1016/0268-0033(86)90147-6. View

Ploumis A, Simpson A, Cha T, Herzog J, Wood K . Coronal Spinal Balance in Adult Spine Deformity Patients With Long Spinal Fusions: A Minimum 2- to 5-Year Follow-up Study. J Spinal Disord Tech. 2013; 28(9):341-7. DOI: 10.1097/BSD.0b013e3182aab2ff. View

Guo X, Zhang X, Ding W, Yang D, Ma L, Xie D . [Imaging study of paravertebral muscle degeneration in degenerative lumbar instability]. Zhonghua Wai Ke Za Zhi. 2014; 52(8):571-5. View

Tang Y, Yang S, Chen C, Luo K, Chen Y, Wang D . Assessment of the association between paraspinal muscle degeneration and quality of life in patients with degenerative lumbar scoliosis. Exp Ther Med. 2020; 20(1):505-511. PMC: 7271738. DOI: 10.3892/etm.2020.8682. View

Delmonico M, Harris T, Visser M, Park S, Conroy M, Velasquez-Mieyer P . Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr. 2009; 90(6):1579-85. PMC: 2777469. DOI: 10.3945/ajcn.2009.28047. View

Shafaq N, Suzuki A, Matsumura A, Terai H, Toyoda H, Yasuda H . Asymmetric degeneration of paravertebral muscles in patients with degenerative lumbar scoliosis. Spine (Phila Pa 1976). 2012; 37(16):1398-406. DOI: 10.1097/BRS.0b013e31824c767e. View

10.

Lin G, Ma Y, Xiao Y, Xiang D, Luo J, Zhang G . The effect of posterior lumbar dynamic fixation and intervertebral fusion on paraspinal muscles. BMC Musculoskelet Disord. 2021; 22(1):1049. PMC: 8690627. DOI: 10.1186/s12891-021-04943-w. View

11.

Panjabi M . Clinical spinal instability and low back pain. J Electromyogr Kinesiol. 2003; 13(4):371-9. DOI: 10.1016/s1050-6411(03)00044-0. View

12.

Kebaish K, Neubauer P, Voros G, Khoshnevisan M, Skolasky R . Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender. Spine (Phila Pa 1976). 2010; 36(9):731-6. DOI: 10.1097/BRS.0b013e3181e9f120. View

13.

Campbell W, Vasconcelos O, Laine F . Focal atrophy of the multifidus muscle in lumbosacral radiculopathy. Muscle Nerve. 1998; 21(10):1350-3. DOI: 10.1002/(sici)1097-4598(199810)21:10<1350::aid-mus21>3.0.co;2-4. View

14.

Rossi A, Zoico E, Goodpaster B, Sepe A, Francesco V, Fantin F . Quantification of intermuscular adipose tissue in the erector spinae muscle by MRI: agreement with histological evaluation. Obesity (Silver Spring). 2010; 18(12):2379-84. PMC: 5278643. DOI: 10.1038/oby.2010.48. View

15.

Liu W, Li Y, Qiu J, Shi B, Liu Z, Sun X . Intra-operative Neurophysiological Monitoring in Patients Undergoing Posterior Spinal Correction Surgery with Pre-operative Neurological Deficit: Its Feasibility and High-risk Factors for Failed Monitoring. Orthop Surg. 2023; 15(12):3146-3152. PMC: 10693999. DOI: 10.1111/os.13914. View

16.

Kang C, Shin M, Kim S, Lee S, Lee C . MRI of paraspinal muscles in lumbar degenerative kyphosis patients and control patients with chronic low back pain. Clin Radiol. 2007; 62(5):479-86. DOI: 10.1016/j.crad.2006.12.002. View

17.

Minetama M, Kawakami M, Nakatani T, Teraguchi M, Nakagawa M, Yamamoto Y . Lumbar paraspinal muscle morphology is associated with spinal degeneration in patients with lumbar spinal stenosis. Spine J. 2023; 23(11):1630-1640. DOI: 10.1016/j.spinee.2023.06.398. View

18.

Bess S, Boachie-Adjei O, Burton D, Cunningham M, Shaffrey C, Shelokov A . Pain and disability determine treatment modality for older patients with adult scoliosis, while deformity guides treatment for younger patients. Spine (Phila Pa 1976). 2009; 34(20):2186-90. DOI: 10.1097/BRS.0b013e3181b05146. View

19.

Ozcan-Eksi E, Eksi M, Akcal M . Severe Lumbar Intervertebral Disc Degeneration Is Associated with Modic Changes and Fatty Infiltration in the Paraspinal Muscles at all Lumbar Levels, Except for L1-L2: A Cross-Sectional Analysis of 50 Symptomatic Women and 50 Age-Matched.... World Neurosurg. 2018; 122:e1069-e1077. DOI: 10.1016/j.wneu.2018.10.229. View

20.

Schwab F, Patel A, Ungar B, Farcy J, Lafage V . Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976). 2010; 35(25):2224-31. DOI: 10.1097/BRS.0b013e3181ee6bd4. View