The Correlation Between Paralumbar Muscle Degeneration And Spine Pelvis Parameters

Purpose:Analyze the correlation between the degeneration of the lumbar paraspinal muscles and spine-pelvic parameters in the normal population,and explore the relationship between the degeneration of the paraspinal muscles in the normal population and the degenerative changes of the lumbar spine.Methods:Using retrospective research methods,we included those who had a physical examination in our hospital’s health examination center from July 2017 to July 2020 as the research objects.According to different ages,they are divided into three age groups: 40-49 years old,50-59 years old,and 60-69 years old.All the included populations completed the X-ray and MRI examination of the lumbar spine.The image management system software was used to measure the parameters of the spine-pelvic sagittal plane on the lateral X-ray film of the lumbar spine.Using the drawing tool on the image management system software,draw the cross-sectional area of the L3/4,L4/5,L5/S1 intervertebral space level paraspinal muscles(the erector spinae and multifidus)on the lumbar MRI cross section area and the CSA area of the lower endplates of the L3,L4,and L5 vertebral bodies were measured by software to measure the cross-sectional area of the paraspinal muscles and the vertebral body.Calculate paraspinal muscle CSA/centrum CSA,analyze the correlation between paraspinal muscle CSA/centrum CSA and spine-pelvic parameters in different age groups.Results:A total of 180 health checkups were included,including 55 numbers in the 40-49 age group,71 numbers in the 50-59 age group,and 54 numbers in the 60-69 age group.From the 40-49 age group to the 60-69 age group,the paraspinal muscle CSA/centrum CSA at each intervertebral space level showed a decreasing trend.At L3/4,L4/5,and L5/S1 intervertebral space levels,there were statistical differences in paraspinal muscle CSA/centrum CSA in each age group(P<0.05).In the 40-49 age group,L3/4,L4/5,L5/S1 paravertebral muscle CSA/ centrum CSA were significantly correlated with sacral slope(SS)(r=0.540,0.559,0.558,P<0.01),lumbar lordosis(LL)(r=0.505,0.558,0.570,P<0.001),while the correlation with pelvic incidence angle(PI)was moderate(r=0.415,0.432,0.417,P<0.01).In the 50-59 age group,CSA/CSA of paravertebral muscles at L3/4,L4/5 and L5/S1 intervertebral levels were moderately correlated with SS(r=0.393,0.425,0.445,P<0.001)and LL(r=0.369,0.469,0.430,P<0.01),while the correlation with pelvic incidence angle(PI)was weak(r=0.365,0.355,0.236,P<0.05).In the 60-69 age group,CSA of paraspinal muscles at L3/4,L4/5,and L5/S1 intervertebral levels were significantly correlated with SS(r=0.685,0.553,0.523,P<0.001)and LL(r=0.700,0.623,0.574,P<0.001),while the correlation with pelvic incidence angle(PI)was moderate(r=0.491,0.419,0.372,P<0.01).PI-LL is weakly correlated with the L5/S1 paraspinal muscle CSA/vertebral body CSA ratio in the 50-59 age group(r=-0.277,P<0.05).In the 60-69 age group,CSA of paraspinal muscles at L3/4,L4/5,and L5/S1 intervertebral levels were moderate correlated with PI-LL(r=-0.316,-0.300,-0.291,P<0.05).Conclusion:In the normal population,the cross-sectional area of the paraspinal muscles gradually decreases with age,and the cross-sectional area of the lumbar paraspinal muscles is positively correlated with the spine-pelvic parameters SS,LL,and PI,and negatively correlated with PI-LL.In particular,the risk of local lumbar imbalance in people over 50 years old is increased,suggesting that there may be a certain correlation between paraspinal muscle degeneration and lumbar degenerative changes in the elderly.