Relationship between degeneration of paravertebral muscles and rotation of apical vertebrae in patients with adult degenerative scoliosis

English Keywords:Adult degenerative scoliosis  Multifidus  Erector spinae  Psoas muscle  Rotation of apical vertebrae

English Abstract:

  【Abstract】 Objectives: To analyze the relationship between the degeneration of multifidus, erector spinae and psoas muscle and the rotation of apical vertebrae in patients with adult degenerative scoliosis(ADS). Methods: The clinical data of patients with ADS treated in our hospital from January 2017 to July 2019 was collected. The parameters of muscles at the level of the apex of the curvature, including cross-sectional area(CSA), fat saturation fraction(FSF), ratio of CSAconcave to CSAconvex(rCSA), ratio of FSFconcave to FSFconvex(rFSF) and apical vertebra rotation(AVR) were measured on lumbar magnetic resonance imaging(MRI). Paired-sample t-test was used to analyze the differences between the values of muscles on concave and convex sides. Pearson correlation was used to analyze the correlation between the values of the muscles and AVR. Results: A total of 96 patients(18 males and 78 females) were included, with an average age of 64.64±7.18 years old; lumbar lordosis angle 20.19°±17.61°; Cobb angle 24.70°±10.41°; AVR 10.94°± 6.47°, all directions of rotation toward the convex side of scoliosis. At the level of the apex of the curvature, CSAconcave of multifidus muscle, erector spinae and psoas muscle were significantly larger than CSAconvex (P<0.05). FSFconcave of multifidus muscle was significantly larger than FSFconvex(P<0.01). FSFconvex of erector spinae was significantly larger than FSFconcave(P<0.05). There was no significant difference between FSF on both sides of psoas muscle(P>0.05). AVR was negatively correlated with CSAconvex of multifidus muscle and FSFconvex of psoas muscle(r=-0.225, -0.292, P<0.05) and positively correlated with rCSA of multifidus muscle, rFSF of erector spinae(r=0.396, 0.215, P<0.05). Conclusions: There is a significant correlation between the parameters of multifidus,erector spinae and the psoas muscle and AVR in ADS patients. The degeneration of the multifidus muscle and the erector spinae may be involved in the rotation of the vertebrae.