| Objective:To determine the association of paraspinal muscles fat signal fraction(FSF)and cross-sectional area(CSA)of q-Dixon with intervertebral disc degeneration(IDD),age,sex,body mass index(BMI),and diabetes in patients with low back pain.Assessing the relationship between paraspinal muscle FSF and CSA and lumbar spine function.Methods:69 patients with low back pain underwent routine magnetic resonance imaging and q-Dixon.We determined CSA and FSF of erector spinae,multifidus and psoas at the L3 / L4 disc level,and the discs were assessed by Pfirrmann Grades,Lumbar function were evaluated with Japanese Orthopaedic Association(JOA)scores.Spearman correlation analysis was used to evaluate the relationship between JOA scores and FSF and CSA,The differences in FSF and CSA of paravertebral muscle between different genders and between diabetic and non-diabetic patients determined by t test.Spearman correlation analysis were used to analyze the correlation between age,BMI,IDD and FSF and CSA of paraspinal muscles.A multivariate linear regression analysis was performed to determine the independent association that IDD,age,sex,BMI and diabetes.Results:1.JOA scores had correlation with FSF and CSA of paraspinal muscles,and JOA scores had a moderate correlation with FSF of the multifidus(r=﹣0.421,P=0.014).2.Women had larger FSF in erector spinae,multifidus and psoas than men,The differences in FSF between the sexes were statistically significant(P=0.001、P<0.001、P=0.023);Men had larger CSA in psoas than men(P=0.048).There were no significant differences between CSA of the erector spinae and multifidus in different genders.3.Diabetics had larger FSF in erector spinae,multifidus and psoas,the difference of FSF between diabetic patients and non-diabetic patients was statistically significant(P=0.003、P=0.001、P=0.037);Diabetics had smaller CSA in erector spinae,multifidus and psoas,the difference of CSA between diabetic patients and non-diabetic patients was statistically significant(P=0.014、P<0.001、P=0.041).4.Age and BMI were correlated to FSF of paraspinal muscles,IDD had a moderate correlation with FSF of the erector spinae(r=0.353,P=0.032)and the multifidus(r=0.634,P=0.001),but there was no significant correlation between IDD and FSF of the psoas(P=0.653).5.Age had a negative correlation with CSA of paraspinal muscles,there were no correlation between BMI and CSA in paraspinal muscles,IDD had a moderate correlation with CSA of the multifidus(r=-0.374,P=0.022),there was no significant correlation between IDD and CSA of erector spinae and psoas.6.Multiple linear regression analysis showed gender,diabetes,age,BMI,and IDD are independent factors impact on FSF of the erector spinae and multifidus;Gender,diabetes,age,BMI are independent factors impact on FSF of the psoas.Diabetes and age are independent factors impact on CSA of the erector spinae;Diabetes、age and IDD are independent factors impact on CSA of multifidus;Sex、diabetes and age are independent factors impact on CSA of the psoas.Conclusion:1.The FSF and CSA of the paravertebral muscles are related to lumbar spine function,and the FSF of multifidus muscle are closely related to lumbar spine function.2.In addition to muscle loss,paravertebral muscle degeneration is accompanied by fat infiltration.Diabetes can increase fat content and decrease muscle mass in paravertebral muscles.Fat infiltration of the multifidus muscle and erector spinae and atrophy of the multifidus muscle have a certain correlation with intervertebral disc degeneration.Therefore,q-Dixon can be used to measure the FSF of paravertebral muscles quantitatively,which can guide clinical rational rehabilitation training in a timely manner and choose the appropriate surgical pathway. |
PDF Full Text Request