Hida Tetsuro, Eastlack Robert K, Kanemura Tokumi, Mundis Gregory M, Imagama Shiro, Akbarnia Behrooz A
San Diego Spine Foundation, San Diego, CA, USA; Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan; Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
San Diego Spine Foundation, San Diego, CA, USA; Scripps Clinic, La Jolla, CA, USA.
J Orthop Sci. 2021 Jan;26(1):69-74. doi: 10.1016/j.jos.2019.09.006. Epub 2020 Oct 29.
The quantity and quality of spinal muscles in patients with degenerative spinal diseases and various backgrounds such as age, gender, or race is unclear. We quantitatively evaluated the cross-sectional area (CSA) and fatty degeneration of the muscles around the spine, using magnetic resonance imaging (MRI) in patients with degenerative spinal disease, and studied the effects of age, gender, and race in multicenter retrospective study.
The subjects were Caucasian and Asian patients with degenerative lumbar disease who underwent L4-5 single level spinal fusion surgery at centers in the United States and Japan. Using preoperative axial T2 MRI at the L4-5 disc level, the cross-sectional areas of the psoas and paraspinal muscles were measured. Fat infiltration was measured using the threshold method, and percent fat area (%FA) was calculated for each muscle. The muscle/disc area ratio (MDAR) was used to control for size differences per patient. T-test, Pearson's correlation coefficient, partial correlation, and multiple linear regression were used for statistical analysis.
In total, 140 patients (53 men; 87 women; mean age, 69.2 years) were analyzed. Age was similar in Caucasians (n = 64) and Asians (n = 76). MDARs were larger in Caucasians for paraspinal and psoas muscles (p < 0.005). Percent FA of psoas was similar in Caucasians and Asians, but greater in the paraspinal muscles of Asians (p < 0.05). After controlling for race and gender, age was correlated negatively with MDAR (p < 0.001) and positively with %FA (p < 0.001). In the multiple linear regression analysis, age, gender, and race were independently affected by MDAR and %FA.
Lumbar muscle mass and quality were affected by age, gender, and race, independently, in patients with degenerative lumbar disease.
患有退行性脊柱疾病且具有不同背景（如年龄、性别或种族）的患者，其脊柱肌肉的数量和质量尚不清楚。我们使用磁共振成像（MRI）对患有退行性脊柱疾病的患者脊柱周围肌肉的横截面积（CSA）和脂肪变性进行了定量评估，并在多中心回顾性研究中研究了年龄、性别和种族的影响。
研究对象为在美国和日本各中心接受L4-5单节段脊柱融合手术的患有退行性腰椎疾病的白种人和亚洲患者。使用术前L4-5椎间盘水平的轴向T2 MRI测量腰大肌和椎旁肌的横截面积。采用阈值法测量脂肪浸润，并计算每块肌肉的脂肪面积百分比（%FA）。肌肉/椎间盘面积比（MDAR）用于控制每位患者的大小差异。采用t检验、Pearson相关系数、偏相关和多元线性回归进行统计分析。
共分析了140例患者（53例男性；87例女性；平均年龄69.2岁）。白种人（n = 64）和亚洲人（n = 76）的年龄相似。白种人的椎旁肌和腰大肌的MDAR更大（p < 0.005）。白种人和亚洲人的腰大肌%FA相似，但亚洲人椎旁肌的%FA更大（p < 0.05）。在控制种族和性别后，年龄与MDAR呈负相关（p < 0.001），与%FA呈正相关（p < 0.001）。在多元线性回归分析中，年龄、性别和种族独立影响MDAR和%FA。
在患有退行性腰椎疾病的患者中，腰椎肌肉质量和质量分别受年龄、性别和种族的影响。
