Risk Factor Analysis for Fat Infiltration in the Lumbar Paraspinal Muscles in Patients With Lumbar Degenerative Diseases

Abstract

Introduction This study aimed to investigate factors related to fat infiltration in patients with lumbar degenerative diseases (lumbar disc herniation and/or spinal stenosis), examining a wide range of potential risk variables. Materials and methods We studied consecutive adult patients who underwent posterior lumbar spinal surgery for degenerative diseases at our hospital between July 2013 and June 2017. Preoperative magnetic resonance imaging was used to evaluate the presence or absence of fat infiltration at the level of the L4-5 lumbar paraspinal muscles using Kjaer’s evaluation method. Patients without fat infiltration (0%–10%) were rated as grade 0, grade 1 for moderate fat infiltration (10%–50%), and grade 2 for severe fat infiltration (>50%). Patients were then divided into two groups: Group A (without fat infiltration, grade 0) and Group B (with fat infiltration, grade 1 or 2). Detailed patient clinical data were collected and analyzed. Results A total of 205 consecutive patients were enrolled; 54 (26.3%) patients were assigned to Group A and 151 (73.7%) to Group B. Logistic regression analysis revealed two independent risk factors for fat infiltration of the lumbar paraspinal muscles: female sex and older age (P < .001). Discussion Fat infiltration of the lumbar paraspinal muscles is reported to be associated with the development of pain and dysfunction of the lumbar region and postoperative complications of spinal instrumented fusion surgery. To the best of our knowledge, no previous studies have identified female sex and older age as independent risk factors for fat infiltration in the lumbar paraspinal muscles using multivariate analysis. Conclusions Female sex and older age were independent risk factors for fat infiltration in the lumbar paraspinal muscles. The results of the current study may provide useful information for the study of preventive measures for fat infiltration.

Development, validation, and visualization of a web-based nomogram to predict the effect of tubular microdiscectomy for lumbar disc herniation

“…The results presented by Gruber et al ( 25 ) showed that with increasing age, the healing process of the outer plate after surgery was not be enough to effectively reconstruct the outer ring, and the lower back muscles were atrophied in older patients than in younger patients and the muscle group's support for the lumbar spine was weakened, which was more likely to cause postoperative recurrence of intervertebral disc herniation. In addition, the study by Suzuki et al ( 26 ) found that the elderly were also more prone to lumbar muscle strain and paraspinal muscle fat infiltration. All these factors are related to long-term chronic low back pain, and postoperative recurrence and low back pain will cause postoperative complications.…”

Association of Preoperative Osteoporotic Vertebral Compression Fractures with Muscle Atrophy in Lumbar Spinal Stenosis: A Retrospective Cohort Study

“…Our focus on the L4/5 level was based on reports suggesting a higher susceptibility to fat infiltration in the lower lumbar vertebrae than in the upper lumbar vertebrae. 19 ) This method, which has been validated by several previous studies, 20 , 21 , 22 , 23 , 24 ) categorizes fat infiltration in the paraspinal muscles into three grades based on the amount of fat within the paraspinal muscles: grade 0, 0%–10%; grade 1, 10%–50%; and grade 2, >50%. This assessment was conducted visually using MRI ( Fig.…”