Imaging Study Of Degenerative Lumbar Spondylolisthesis And Paravertebral Muscle Degeneration

Objective:To compare the changes of paravertebral muscles(polyfidus,erector and psoas major)both in patients with degenerative lumbar spondylolisthesis and normal subjects by means of MRI.To observe the degree of paravertebral muscle degeneration and analyze the relationship between paravertebral muscle degeneration and degenerative lumbar spondylolisthesis.Methods:A retrospective study was conducted to select 63 patients with degenerative lumbar spondylolisthesis hospitalized in Qilu Hospital of Shandong University from July 2016 to September 2018 as the study subjects(degenerative group).63 patients without lumbar degeneration were selected as the control group.The gender,age and body mass index were matched between the two groups.ImageJ software was used to measure the cross-sectional area CSA and fat infiltration percentage of L4-S1 intervertebral disc on MRI T2WI in two groups.The measured data was analyzed by two independent sample t test(SPSS 13.0).Results:At the L4-L5 and L5-S1 intervertebral disc level,there was no significant difference in the cross-sectional area of multifidus muscle between the degenerative group and the normal control group;the percentage of fat infiltration in the degenerative group was larger than that in the control group(P<0.05);at the L4-L5 and L5-S1 intervertebral disc level,the cross-sectional area of vertical muscle in the degenerative group was larger than that in the normal control group(P<0.05).The percentage of fat infiltration in degenerative group was smaller than that in normal control group;the differences were both statistically significant(P<0.05);at the middle level of L4-L5 and L5-S1 intervertebral disc,there was no significant difference in the cross-sectional area of psoas major muscle between degenerative group and normal control group;compared with the percentage of fat infiltration in degenerative group,the percentage of fat infiltration in degenerative group was smaller than that in normal control group,and the difference was statistically significant(P<0.05).Conclusion:The patients with degenerative lumbar spondylolisthesis showed that the multifidus muscle fatty infiltration increased,the fat infiltration of erector spine muscle decreased,the cross-sectional area of erector spine muscle increased and the psoas muscle fatty infiltration decreased.As far as current research is concerned,the increased infiltration of polyfidus muscle fat may be a risk factor for degenerative lumbar spondylolisthesis,accompanied by compensatory hypertrophy of erector spine muscle and psoas major muscle or increase of compensatory muscle fibers.