Liu Shuang, Shi Qi, Da Wei-Wei, Xue Chun-Chun, Chen Lin, Li Yu-Nan, Xue Yong-Peng, Du Wen-Lan, Li Xiao-Feng
Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Institute of Spinal Diseases, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Spine (Phila Pa 1976). 2025 Jun 15;50(12):841-848. doi: 10.1097/BRS.0000000000005140. Epub 2024 Aug 28.
A retrospective, cross-sectional cohort study.
This study aimed to investigate the association between paraspinal muscle parameters and single-segment degenerative lumbar spondylolisthesis (DLS).
The relationship between lumbar paraspinal muscle morphology and single-segment DLS remains unclear.
A retrospective review was conducted on 115 patients with L4/5 single-segment DLS and 105 subjects without DLS. Two independent investigators assessed the relative cross-sectional area and fat infiltration rate of the multifidus, erector spinae, and psoas major at L3/4, L4/5, and L5/S1 levels, comparing these measurements between the 2 groups. In addition, binary logistic regression analysis was performed with DLS as the dependent variable to analyze the relative cross-sectional area and fat infiltration rate of different paraspinal muscles. Within the DLS group, the correlation between paraspinal muscle characteristics and the anteroposterior diameter of the spinal canal was examined.
The fat infiltration rate of multifidus, erector spinae, and psoas major was higher in the DLS group than in the control group, whereas the relative cross-sectional area of multifidus and psoas major was lower in the DLS group. Binary logistic regression analysis revealed a significant correlation between the fat infiltration rate of multifidus and psoas major and DLS. The relative cross-sectional area of multifidus and erector spinae was significantly smaller below the affected segment in the DLS group compared with the control group. A significant positive correlation was observed between the relative cross-sectional area of multifidus and erector spinae and the anteroposterior diameter of the spinal canal.
There is a close association between paraspinal muscle degeneration and single-segment DLS, with an increased relative cross-sectional area of the multifidus and psoas major possibly being risk factors for single-segment DLS. The restoration or enhancement of paraspinal muscle function could potentially serve as a pivotal target for the prevention and treatment of single-segment DLS.
Level III.
一项回顾性横断面队列研究。
本研究旨在调查椎旁肌参数与单节段退变性腰椎滑脱（DLS）之间的关联。
腰椎椎旁肌形态与单节段DLS之间的关系仍不清楚。
对115例L4/5单节段DLS患者和105例无DLS的受试者进行回顾性研究。两名独立研究人员评估了L3/4、L4/5和L5/S1水平多裂肌、竖脊肌和腰大肌的相对横截面积和脂肪浸润率，并比较了两组之间的这些测量值。此外，以DLS为因变量进行二元逻辑回归分析，以分析不同椎旁肌的相对横截面积和脂肪浸润率。在DLS组内，检查椎旁肌特征与椎管前后径之间的相关性。
DLS组多裂肌、竖脊肌和腰大肌的脂肪浸润率高于对照组，而DLS组多裂肌和腰大肌的相对横截面积较低。二元逻辑回归分析显示，多裂肌和腰大肌的脂肪浸润率与DLS之间存在显著相关性。与对照组相比，DLS组患节段以下多裂肌和竖脊肌的相对横截面积明显较小。多裂肌和竖脊肌的相对横截面积与椎管前后径之间存在显著正相关。
椎旁肌退变与单节段DLS密切相关，多裂肌和腰大肌相对横截面积增加可能是单节段DLS的危险因素。恢复或增强椎旁肌功能可能是预防和治疗单节段DLS的关键靶点。
三级。
