Mu Xiaoyu, Zhao Chongyu, Shan Zhitao, Deng Li, Zhou Xiaowei, Li Li
Department of Orthopedics and Traumatology, Kunming Municipal Hospital of Traditional Chinese Medicine (The Third Affiliated Hospital of Yunnan University of Chinese Medicine) Kunming 650000, Yunnan, China.
Heilongjiang University of Chinese Medicine Harbin 150000, Heilongjiang, China.
Am J Transl Res. 2025 Jun 15;17(6):4247-4255. doi: 10.62347/HKEC4010. eCollection 2025.
To investigate the correlation between the severity of lumbar spinal stenosis (LSS) and the atrophy of lumbar paraspinal muscles.
A retrospective analysis was conducted on 200 patients with LSS (stenosis group) and 60 individuals without lumbar spine disease (control group) treated at the Department of Orthopedics, Kunming Traditional Chinese Medicine Hospital, from January 2022 to October 2024. Using a 1.5T MRI system, we measured the total cross-sectional area (TCSA) and total fat-free cross-sectional area (TFCSA) of the multifidus, erector spinae, and psoas major muscles. Muscle atrophy was evaluated using the TFCSA/TCSA ratio, and its correlation with LSS severity was analyzed.
The stenosis group showed significantly lower TFCSA/TCSA ratios in the multifidus, erector spinae, and psoas major compared to controls (P<0.05). LSS severity was negatively correlated with the TFCSA/TCSA ratios of the multifidus (r=-0.504, P<0.05) and erector spinae (r=-0.562, P<0.05), but not with the psoas major (P>0.05). Similarly, the number of stenotic segments was negatively correlated with multifidus (r=-0.381) and erector spinae (r=-0.420) atrophy (P<0.05). TFCSA/TCSA ratios were significantly lower on the symptomatic side for all three muscles (all P<0.05).
The severity and extent of LSS are significantly associated with atrophy of the multifidus and erector spinae, but not the psoas major. Greater muscle atrophy corresponds to a higher number of stenotic segments.
探讨腰椎管狭窄症（LSS）严重程度与腰段椎旁肌萎缩之间的相关性。
对2022年1月至2024年10月在昆明市中医医院骨科就诊的200例LSS患者（狭窄组）和60例无腰椎疾病的个体（对照组）进行回顾性分析。使用1.5T MRI系统，测量多裂肌、竖脊肌和腰大肌的总横截面积（TCSA）和总无脂肪横截面积（TFCSA）。采用TFCSA/TCSA比值评估肌肉萎缩情况，并分析其与LSS严重程度的相关性。
与对照组相比，狭窄组多裂肌、竖脊肌和腰大肌的TFCSA/TCSA比值显著降低（P<0.05）。LSS严重程度与多裂肌（r=-0.504，P<0.05）和竖脊肌（r=-0.562，P<0.05）的TFCSA/TCSA比值呈负相关，但与腰大肌无关（P>0.05）。同样，狭窄节段数与多裂肌（r=-0.381）和竖脊肌（r=-0.420）萎缩呈负相关（P<0.05）。所有三块肌肉的TFCSA/TCSA比值在症状侧均显著降低（均P<0.05）。
LSS的严重程度和范围与多裂肌和竖脊肌萎缩显著相关，但与腰大肌无关。肌肉萎缩越严重，狭窄节段数越多。
