Department of Spinal Surgery, Hebei Medical University Third Hospital, Shijiazhuang, China.
Hebei Joint International Research Center for Spinal Diseases, Shijiazhuang, China.
Orthop Surg. 2024 Nov;16(11):2722-2731. doi: 10.1111/os.14185. Epub 2024 Aug 8.
Clarifying paraspinal muscle (PM) change in degenerative lumbar scoliosis (DLS) is positive to evaluate the progression of scoliosis. This research compares the characteristic of PM change among different coronal sub-types of DLS and explores its potential clinical significance.
A total of 84 DLS patients between June 2019 to December 2021 were retrospectively analyzed. Patients were classified into three types based on the coronal balance distance (CBD): Type A, CBD <3 cm; Type B: C7 Plumb Line (C7PL) shifted to the concave side of the curve, and CBD >3 cm; Type C: C7PL shifted to the convex side of the curve, and CBD >3 cm. Fat infiltration rates in the multifidus (MS) and erector spinae (ES) at the apex of the main and fractional curves, and spinopelvic parameters were analyzed statistically. Pearson's or Spearman's correlation was applied to analyze the correlation between asymmetric degree of PM change and these parameters in three types.
There were 62 cases with coronal sub-Type A, 6 cases with Type B, and 16 cases with Type C. Patients in Type B and C demonstrated higher fat infiltration in MS on the concave side of both the main and fractional curves when compared to those in Type A. The asymmetric degree of ES change was positively correlated with CBD at the apex of the main curve in Type B and at the apex of the fractional curve in Type C respectively, and that of MS was positively correlated with apical vertebral rotation, while negatively strong-correlated with pelvic incidence and sacral slope in Type C.
PM fatty infiltration presented difference among varied coronal sub-types of DLS patients. The CBD in Type B and C patients was correlated with the asymmetric degree of ES change.
明确退变性腰椎侧凸（DLS）中脊柱旁肌（PM）的变化，有助于评估脊柱侧凸的进展。本研究比较了不同冠状亚型 DLS 中 PM 变化的特征，并探讨其潜在的临床意义。
回顾性分析 2019 年 6 月至 2021 年 12 月间的 84 例 DLS 患者。根据冠状平衡距离（CBD）将患者分为 3 型：A型，CBD<3cm；B 型：C7 铅垂线（C7PL）向曲线凹侧偏移，CBD>3cm；C 型：C7PL 向曲线凸侧偏移，CBD>3cm。统计分析主曲线和分曲线顶点多裂肌（MS）和竖脊肌（ES）的脂肪浸润率以及脊柱骨盆参数。采用 Pearson 或 Spearman 相关分析分析 3 型中 PM 变化不对称程度与这些参数之间的相关性。
A 型 62 例，B 型 6 例，C 型 16 例。B 型和 C 型患者主曲线和分曲线凹侧 MS 的脂肪浸润程度均高于 A 型患者。B 型主曲线顶点 CBD 与 ES 变化不对称程度呈正相关，C 型分曲线顶点 CBD 与 ES 变化不对称程度呈正相关，C 型 MS 与顶椎旋转呈正相关，与骨盆入射角和骶骨斜率呈负相关。
不同冠状亚型 DLS 患者的 PM 脂肪浸润存在差异。B 型和 C 型患者的 CBD 与 ES 变化的不对称程度相关。
