Assessment of fatty infiltration of the multifidus muscle in patients with adolescent idiopathic scoliosis through evaluation by magnetic resonance imaging compared with histological analysis: a diagnostic accuracy study

Wajchenberg, Marcelo; Astur, Nelson; Fernandes, Eloy A.; Paredes‐Gamero, Edgar Julian; Luciano, Rafael Paiva; Schmidt, Beny; Oliveira, Acary Souza Bullé; Martins, Délio Eulálio

doi:10.1097/bpb.0000000000000578

Cited by 17 publications

(16 citation statements)

References 23 publications

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“…In recent decades, there have been multiple reports of bilateral PSM asymmetry [ 2 , 5 – 11 ]. Abnormal hyperintense signal of PSM has been identified on the concave side by magnetic resonance imaging [ 2 , 11 ], which was consistent with the histologic finding of increased fibrosis and fatty infiltration on concavity [ 6 , 9 ]. Increased electrical activity of PSM was also found on the convex side [ 8 , 10 ].…”

Section: Introductionsupporting

confidence: 62%

Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

et al. 2020

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Section: Introductionsupporting

confidence: 62%

Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

et al. 2020

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“…Our findings related to tissue composition are consistent with prior studies, although again only two prior studies have made compositional comparisons between concave and convex sides of scoliotic curvature in AIS. In both studies, elevated levels of collagen 17 and fatty infiltration 17,18 were found on the concave side of the scoliotic curve. In addition, Wajchenberg et al 18 reported that they found no relationship between amount of histologically observed fatty infiltration and curve severity.…”

Section: Discussionmentioning

confidence: 87%

“…In both studies, elevated levels of collagen 17 and fatty infiltration 17,18 were found on the concave side of the scoliotic curve. In addition, Wajchenberg et al 18 reported that they found no relationship between amount of histologically observed fatty infiltration and curve severity. However, the actual proportions of fibrotic or fatty tissue relative to the sample area were not quantified in either of these studies, and comparisons were only made based on the number of samples demonstrating the “presence” or “absence” of what was considered abnormal infiltration, making absolute comparisons between our own data and prior literature difficult.…”

Section: Discussionmentioning

confidence: 87%

Paraspinal muscle morphology and composition in adolescent idiopathic scoliosis: A histological analysis

et al. 2021

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Background Adolescent idiopathic scoliosis (AIS) is a condition resulting in spinal deformity and tissue adaptation of the paraspinal muscles. Although prior studies have demonstrated asymmetries in fiber type and other energetic features of muscle on the concave side of the curve, muscle morphology, architecture, and composition have not been evaluated. Therefore, the purpose of this study was to compare differences in paraspinal muscle microarchitecture and composition between concave and convex sides of a scoliotic curve in individuals with AIS. Methods Paraspinal muscle biopsies were obtained at the apex of the scoliotic curve in 29 individuals with AIS undergoing surgical deformity correction. Histological assays were performed to quantify fiber size, evidence of muscle degeneration and regeneration, and tissue composition (proportion of muscle, collagen, and fat). Differences between contralateral muscle samples were compared using two‐tailed paired Student's t tests, and relationships between clinical characteristics (age and curve severity) and muscle characteristics were investigated using Pearson correlations. Results Muscle fibers were significantly larger on the convex side of the curve apex (P = .001), but were lower than literature‐based norms for healthy paraspinal muscle. There were no differences in amount of degeneration/regeneration (P = .490) or the proportion of muscle and collagen (P > .350) between the concave and convex sides, but high levels of collagen were observed. There was a trend toward higher fat content on the concave side (P = .074). Larger fiber size asymmetries were associated with greater age (r = .43, P = .046), and trended toward an association with greater curve severity (r = .40, P = .069). Conclusions This study demonstrates that although muscle fibers are larger on the convex side of the scoliotic curve in AIS, muscles on both sides are atrophic compared to non‐scoliotic individuals, and demonstrate levels of collagen similar to severe degenerative spinal pathologies. These findings provide insight into biological maladaptations occurring in paraspinal muscle in the presence of AIS.

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“…Interestingly, our results also showed PS muscles had high percentages of FAPs of which were more adipogenic and had greater cell proliferation rates compared to the hindlimb muscles. Clinically, PS muscles are known to develop FI in a number of spine conditions such as degenerative disc disease and scoliosis . Most studies of PS FI center on imaging quantification of FI and correlation to clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Rotator Cuff Fibro‐Adipogenic Progenitors Demonstrate Highest Concentration, Proliferative Capacity, and Adipogenic Potential Across Muscle Groups

Lee

Agha

Liu

et al. 2019

Journal Orthopaedic Research

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Fatty infiltration (FI) of rotator cuff (RC) muscles is common in patients with RC tears. Studies have demonstrated that fibro-adipogenic progenitors (FAPs), a population of resident muscle stem cells, are the main contributors of FI, which adversely affects muscle quality and RC repair success. Although FI is common in RC injuries, it is not frequently reported after other musculotendinous injuries. Additionally, studies have shown the development of different pathology patterns across muscle groups suggestive of intrinsic differences in cellular composition and behavior. This study evaluates FAP distribution and differentiation properties across anatomic locations in mice. Muscles from seven different anatomic locations were harvested from PDGFRα-eGFP FAP reporter mice. FAPs were quantified using histology and FACS sorting with BD Aria II with CD31 − /CD45 − /Integrinα7 − /Sca-1 + and PDGFRα reporter signal (n = 3 per muscle). The cells were analyzed for adipogenesis using immunocytochemistry and for proliferation properties with Brdu-Ki67 staining. In a separate group of mice, RC and tibialis anterior muscles received glycerol injection and were harvested after 2 weeks for FI quantification (n = 4). One-way analysis of variance was used for statistical comparisons among groups, with significance at p < 0.05. FAPs from the RC, masseter, and paraspinal muscles were more numerous and demonstrated greater proliferative capacity and adipogenic potency than those from the tibialis anterior and gastrocnemius. The RC demonstrated significantly greater levels of FI than the tibialis anterior after glycerol-injection injury. Clinical Significance: This study suggests differences in FAP distribution and differentiation characteristics may account for the propensity to develop FI in RC tears as compared with other musculotendinous injuries.

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Assessment of fatty infiltration of the multifidus muscle in patients with adolescent idiopathic scoliosis through evaluation by magnetic resonance imaging compared with histological analysis: a diagnostic accuracy study

Cited by 17 publications

References 23 publications

Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

Paraspinal muscle morphology and composition in adolescent idiopathic scoliosis: A histological analysis

Rotator Cuff Fibro‐Adipogenic Progenitors Demonstrate Highest Concentration, Proliferative Capacity, and Adipogenic Potential Across Muscle Groups

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