Background
It is still blank on the relationship between lumbar lordosis morphology and paraspinal muscle in asymptomatic Asian adults. The study aims to investigate the relationships.
Methods
87 asymptomatic adults aged between 18 and 45 years old were enrolled in the retrospective study. Lumbar lordosis morphology, consisting of total lumbar lordosis (LL), proximal lumbar lordosis (PLL), distal lumbar lordosis (DLL), lumbar lordosis apex (LLA) and inflexion point (IP), was evaluated, as well as pelvic incidence (PI) and muscularity of erector spinae (ES) and multifidus (MF). Pearson correlation was performed to analyze the relationship between each other parameter. Cases were stratified according to pelvic incidence (very low < 30°, low 30°-45°, moderate 45°-60°, and high > 60°), comparison between groups was performed by univariance analysis.
Results
PLL revealed a correlation with LLA (r = 0.603, p = 0.002) and inflexion point (r = 0.536, p = 0.004), but did not DLL with LL apex (r = 0.204, p = 0.058) or inflexion point (r = 0.210, p = 0.051). PI revealed a greater correlation with PLL (r=-0.673, p < 0.001) than with DLL (r=-0.237, p = 0.045). Linear stepwise regression analysis also exhibited the correlation between PI and PLL (R2 = 0.452, PLL = 16.2–0.61*PI, p < 0.001). ES muscularity correlated with LL apex (r=-0.279, p = 0.014) and inflexion point (r=-0.227, p = 0.047). Stratification by PI demonstrated PLL increased across groups (p < 0.001), but DLL was comparable between low and moderate PI group (p = 0.329).
Conclusion
Lumbar lordosis morphology correlates to erector spinae muscularity. Proximal lumbar lordosis has a bigger correlation with pelvic incidence than the distal lumbar lordosis. The results are helpful for restoring a rational lumbar lordosis shape in long fusion surgery.