Ayyıldız Aylin, İnceoğlu Selda Çiftci, Ayyıldız Hakan, Kuran Banu
Çam and Sakura City Hospital, Istanbul, Turkey.
Hamidiye Etfal Traning and Research Hospital, Istanbul, Turkey.
Eur Spine J. 2025 May 10. doi: 10.1007/s00586-025-08901-1.
The objective of this study was to investigate the effects of paravertebral muscles and fatty infiltrations of the lumbar region in individuals with varying degrees of bone mineral density, including those with osteoporotic, osteopenic, and healthy control groups.
This single-blind, retrospective, and controlled study included patients aged 50-90 years with lumbar magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA) measurements. The study sample was selected through a simple random sampling method. The patients were divided into three groups based on their T-values in DXA measurements. All patients were evaluated using MRI to measure the anteroposterior thickness of the multifidus, psoas, and erector spinae muscles. Additionally, the Goutallier classification was utilized to assess the degree of muscle fatty infiltration at the L3 vertebra level.
A total of 301 patients were included in the study. The mean age of the patients included in the study was 65.97 ± 8.15 years. A total of 274 patients (91%) were female. A notable reduction in the multifidus muscle was observed in both the osteoporotic and osteopenic groups when compared to the control group. A significant loss was observed in the erector spinae and psoas muscles in the osteoporotic group when compared to the osteopenic and control groups. Furthermore, a notable decline in erector spinae muscle mass was observed in the osteopenic group relative to the control group. The level of muscle fatty infiltration was found to be significantly higher in the osteoporotic group when compared to the control group.
In patients with osteoporosis, there is a notable reduction in lumbar paravertebral muscle mass and an increase in fatty infiltration when compared to the healthy control group. The loss of muscle mass is observable in the multifidus and erector spinae muscles during the osteopenic period, whereas it is observable in the psoas muscle during the osteoporotic period.
本研究的目的是调查不同骨密度程度个体（包括骨质疏松组、骨量减少组和健康对照组）腰椎旁肌肉及脂肪浸润情况。
本单盲、回顾性对照研究纳入了年龄在50 - 90岁之间、进行过腰椎磁共振成像（MRI）和双能X线吸收法（DXA）测量的患者。研究样本通过简单随机抽样方法选取。根据DXA测量的T值将患者分为三组。所有患者均通过MRI评估多裂肌、腰大肌和竖脊肌的前后厚度。此外，采用Goutallier分级法评估L3椎体水平的肌肉脂肪浸润程度。
本研究共纳入301例患者。纳入研究的患者平均年龄为65.97±8.15岁。共有274例患者（91%）为女性。与对照组相比，骨质疏松组和骨量减少组的多裂肌均有明显减少。与骨量减少组和对照组相比，骨质疏松组的竖脊肌和腰大肌有显著损失。此外，与对照组相比，骨量减少组的竖脊肌质量有明显下降。与对照组相比，骨质疏松组的肌肉脂肪浸润水平明显更高。
与健康对照组相比，骨质疏松患者的腰椎旁肌肉质量显著降低，脂肪浸润增加。在骨量减少期，多裂肌和竖脊肌出现肌肉质量损失，而在骨质疏松期，腰大肌出现肌肉质量损失。
