Analysis of correlation between paravertebral muscle degeneration and radiological parameters in patients with adult degenerative scoliosis

English Keywords:Adult degenerative scoliosis  Paravertebral muscle  Sagittal balance

English Abstract:

  【Abstract】 Objectives: To analyze the correlation between degeneration of paravertebral muscles(multifidus and erector spinalis) and the radiological parameters of coronal and sagittal planes in patients with adult degenerative scoliosis(ADS), so as to provide new clues for sagittal imbalance evaluation of ADS patients. Methods: 52 female patients with ADS, aged 55-65 years, were retrospectively collected. Their demographic data were recorded. The cross-sectional area(CSA) and fat saturation fraction(FSF) of paravertebral muscles (multifidus and erector spinalis) at the L1-S1 intervertebral disc level on lumbar magnetic resonance images were measured. The radiological parameters [coronal Cobb angle; sagittal: sagittal vertical axis(SVA), thoracic kyphosis(TK), lumbar lordosis(LL), pelvic tilt(PT), pelvic incidence(PI), sacral slope(SS), PI-LL] were measured. One-way ANOVA was used to analyze FSF at L1-S1 levels of paraspinal muscles, and multiple post-LSD comparisons were made. Pearson correlation analysis was used to compare the relationship between paraspinal muscle degeneration and radiological parameters. Results: There were significant differences in FSF among L1-S1 levels(P<0.01). The FSF of paraspinal muscles at L5/S1 level was significantly higher than that at other levels(P<0.05). Coronal Cobb angle was negatively correlated with CSA at L1/2, L2/3, L3/4, L4/5 levels (r=-0.358, -0.367, -0.329, -0.283, P<0.05). The FSF of paraspinal muscles was positively correlated with PT at all levels of L1-S1(r=0.487, 0.394, 0.354, 0.356, 0.355, P<0.05), but negatively correlated with SS(r= -0.494, -0.440, -0.373, -0.301, -0.300, P<0.05). There was a negative correlation between FSF and LL at L1/2, L2/3 level(r=-0.398, -0.328, P<0.05). Total FSF(TFSF) was positively correlated with PT (r=0.395, P<0.01) and negatively correlated with LL(r=-0.345, P<0.05). There was no statistical significance in Pearson correlation analysis among CSA, FSF and SVA, PI and TK at all levels(P>0.05). BMI was positively correlated with CSA of paravertebral muscles at L1-S1 levels(P<0.05), but there was no statistical significance in Pearson correlation analysis between BMI and FSF(P>0.05). Conclusions: FSF of paravertebral muscles is positively correlated with PT in patients with ADS. Paravertebral muscle degeneration might be involved in the process of spinal degeneration and compensatory mechanism. FSF could potentially be used as an indicator to evaluate the severity of sagittal imbalance in ADS patients.