The Relationship Between Spine-pelvic Sagittal Imbalance And Paravertebral Muscle Degeneration In Degenerative Lumbar Spinal Stenosis

Objective To explore the relationship between paraspinal muscle degeneration and the changes of spinal-pelvis sagittal parameters in patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 28 DLSS patients(experimental group)and 21 healthy volunteers(control group)treated in Ordos Central Hospital from January 2020 to January 2022 were enrolled as the research subjects,and the healthy volunteers were screened from the healthy population in the physical examination center of our hospital.All patients underwent lumbar MRI and X-ray examination of the whole spine according to the unified standard.Relative cross-sectional area(RCSA)and Fatty infiltration ratio(FIR)of paravertebral muscles(multifidus and erector spinae)were measured by axial T2-weighted MRI.Sagittal vertical axis(SVA),thoracic kyphosis(TK),lumbar lordosis(LL),pelvic incidence(PI),sacral slope(SS),and pelvic tilt(PT)were measured by full-length and lateral X-ray of the spine.The data were collated and grouped,and the differences in paravertebral muscle RCSA,FIR and spine-pelvis sagittal parameters between DLSS patients and healthy volunteers in each segment were compared.The correlation between paravertebral muscle parameters of DLSS patients and spine-pelvis sagittal parameters was explored.Results There was no significant difference in gender,age and body mass index(BMI)between the two groups(P > 0.05),which was comparable.PI,PT and SVA in DLSS group were significantly higher than those in control group.In the L4-5 DLSS group,the right ES FIR was negatively correlated with the thoracic kyphosis angle TK(R =-0.536,P < 0.05),and the left MF RCSA was positively correlated with the thoracic kyphosis angle TK(R = 0.502,P < 0.05);In the L5-S1 DLSS group,the right MF RCSA and ES RCSA were positively correlated with the thoracic kyphosis angle TK(R= 0.685;R = 0.615,P < 0.05),while the left had no significance.Conclusion DLSS patients have significant sagittal imbalance compared with healthy people.DLSS patients have higher fat infiltration in paraspinal muscles than healthy people.There is a correlation between paraspinal muscle parameters and spine-pelvis sagittal parameters in DLSS.Conclusion There was significant sagittal imbalance in DLSS patients compared with healthy volunteers.Paravertebral muscle in DLSS patients had higher fat infiltration than healthy volunteers.Paravertebral muscle parameters in DLSS patients were correlated with spinal-pelvic sagittal parameters.