Assessment of the association between paraspinal muscle degeneration and quality of life in patients with degenerative lumbar scoliosis

Abstract

The present study aimed to determine the characteristics of multifidus, erector spinae and psoas major degeneration in elderly patients with degenerative lumbar scoliosis (DLS) and the correlation between asymmetric changes and patient quality of life. A total of 49 patients with lumbar scoliosis (DLS group) and 38 healthy individuals (control group) were prospectively examined. The functional cross-sectional area, cross-sectional area difference index (CDI) and fat infiltration rate (FIR) of the multifidus, erector spinae and psoas major at the apical vertebral level were measured using MRI. The visual analogue scale (VAS) score, Oswestry Disability Index (ODI) and 36-item Short Form Health Survey (SF-36) score were used to evaluate patient quality of life. Correlations between the degree of asymmetric muscular degeneration and quality of life were analysed. The CDI of the multifidus, erector spinal and psoas major was higher in the DLS group compared with that in the control group. The CDI of the multifidus was found to be positively associated with the Cobb angle of lumbar scoliosis. Similar results were obtained for fat infiltration between the two groups. In addition, the CDI and FIR difference index of the multifidus was positively correlated with the VAS score and ODI but negatively correlated with the SF-36 score. The quality of life significantly decreased with increasing asymmetric atrophy and fat infiltration in the multifidus. Thus, strategies to enhance the function of the multifidus may have a positive impact on quality of life (Chinese Clinical Trial Registry, registration date, 2018.11.12; registration no. ChiCTR1800019459.).

Surface electromyography study on asymmetry in paravertebral muscle degeneration in patients with degenerative lumbar scoliosis

“…Yagi [5] found that asymmetry in the CSA between the convex and concave sides in DLS patients was correlated with the Cobb angle in lumbar scoliosis. This is similar to the ndings reported by Tang Y [25], Ding J Z [27], and Xia W [19]. Xie [26] found that the asymmetry of PVM imaging indexes between the convex and concave sides was not only related to the Cobb angle but also had a weak negative correlation with the LL angle.…”

“…At present, domestic and foreign scholars believe that the degeneration of PVMs is characterized by a decrease in muscle volume and an increase in fat in ltration [25]. In DLS patients, the degeneration of PVMs at the same level is asymmetrical, and the degeneration on the concave side is greater than that on the convex side, which manifests on imaging and histology.…”

“…Due to the large load carried by the lumbar dorsal extensor group, scoliosis leads to different forces on each side, and the tension load on the convex side is greater than that on the concave side [26.28]. The high load on the convex side causes compensatory hyperplasia and hypertrophy and inhibits adipocyte differentiation [25], while the concave side shows atrophy and steatosis. Thus, compensatory hypertrophy of the PVMs on the convex side occurs to compensate and maintain the imbalance in the coronal position of the spine and reduce the inclination of the spine to the concave side, while muscle atrophy on the concave side may be associated with increased FI.…”

Risk factors for screw loosening in patients with adult degenerative scoliosis: the importance of paraspinal muscle degeneration

“…Screw loosening is a common complication for patients with fusion and fixation surgery and it is influenced by many factors, such as bone density and operation segment [ 14 , 19 , 20 ]. As an important composition to maintain the stability of spine, the degeneration of paraspinal muscle is of great interest [ 21 , 22 ]. There was one study found that the degeneration of paraspinal muscle was correlated with S1 screw loosening [ 14 ].…”

Female Sexual Dysfunction in Patients with Chronic Low Back Pain

“…When the intervertebral disc, vertebral endplates, spinal bodies and osseous elements, neural canal, facet joints and ligamentum flavum are altered, symptoms of low back pain can occur. Furthermore, changes in one of these elements can lead to subsequent degenerative changes in the other elements that make up the structural bony, ligamentous and muscular components of the spine [1].…”