| Objective:The study used magnetic resonance imaging and specialized image processing software to determine the cross-sectional area and fat infiltration rate of the paravertebral muscle in patients with lumbar spinal stenosis with and without degenerative lumbar scoliosis,and to compare the differences between the two,and to analyze the different patterns of paravertebral muscle changes in different lumbar spine diseases and the correlation between paravertebral muscle changes and lumbar spine degeneration.Methods:Patients with degenerative lumbar scoliosis and lumbar spinal stenosis without the presence of scoliosis who were seen in outpatient clinics or hospitalized at the Affiliated Hospital of Inner Mongolia Medical University from November 2020 to October 2021 were collected and analyzed.General patient data were collected and the characteristics of lumbar lordosis were recorded.The closed polygon tool of the dedicated image analysis software Image J was used to track the contours of the target muscles and selected to measure six paravertebral muscle imaging parameters,including the cross-sectional area of the psoas major muscle,the cross-sectional area of the multifidus muscle,the cross-sectional area of the erector spinae muscle,the fat infiltration rate of the psoas major muscle,the fat infiltration rate of the multifidus muscle,and the fat infiltration rate of the erector spinae muscle,and then the data were analyzed by within-group paired test and between-group independent sample test.Results:Within the degenerative lumbar scoliosis group,the apex of lumbar scoliosis was on the left side in 36 patients and on the right side in 12 patients,with a mean Cobb angle of 24.4°±9.4°.In patients with degenerative lumbar scoliosis,the cross-sectional areas of the psoas major,multifidus and erector spinae muscles on the convex side were 810.00 mm~2±158.15 mm~2,780.90 mm~2±146.38 mm~2and 838.42mm~2±143.48 mm~2,respectively,and the fatty infiltration rate were 10.97%±1.71%,32.49%±5.50%,and 33.12%±5.81%;the cross-sectional areas of concave psoas major,multifidus and erector spinae muscles were 696.23mm~2±129.01mm~2,698.89mm~2±128.50mm~2,831.41mm~2±144.47mm~2,and the fatty infiltration rate were16.86%±2.68%,42.00%±3.95%,and 33.23%±5.20%.There was no statistically significant difference between the cross-sectional areas and fatty infiltration rate of the erector spinae muscle on the convex and concave sides(P>0.05).The differences between cross-sectional areas and fat infiltration rates of psoas major and multifidus muscles on both sides of the convexity were statistically significant(P﹤0.05).The total cross-sectional areas of psoas major,multifidus and erector spinae muscles in the degenerative lumbar scoliosis group were 1507.23mm~2±283.21mm~2,1479.78mm~2±270.88mm~2,1665.83mm~2±286.28mm~2,respectively,and in the lumbar spinal stenosis group were 1625.33mm~2±285.39mm~2,1595.42mm~2±273.67mm~2,and1673.55mm~2±318.10mm~2.The total fatty infiltration rate of psoas major,multifidus,and erector spinae muscles in the degenerative lumbar scoliosis group were13.68%±2.03%,36.98%±3.82%,and 33.18%±4.93%,respectively,and the lumbar spinal stenosis group were 12.64%±10.46%,15.77%±5.17%,and 22.46%±5.08%,respectively.Comparative analysis between the groups revealed no statistically significant differences between the total cross-sectional areas of the erector spinae and the total fatty infiltration rate of the psoas major muscle in the two groups(P>0.05).There was a statistically significant difference between the total cross-sectional areas of the psoas major and multifidus muscles and the total fatty infiltration rate of the multifidus and erector spinae muscles in the two groups(P<0.05).Conclusion:A comparison of the cross-sectional area and fat infiltration rate of the paravertebral muscles in patients with degenerative lumbar scoliosis and in patients with degenerative lumbar scoliosis and lumbar spinal stenosis revealed different patterns of paravertebral muscle changes on different sides of the same lumbar spine disease or between different lumbar spine diseases.In patients with degenerative lumbar scoliosis,the cross-sectional area and fat infiltration of the paravertebral muscles on the convex and concave sides showed asymmetric changes,with an increase in muscle cross-sectional area on the convex side and an increase in fat infiltration on the concave side;this asymmetric change may be a result of the development of degenerative scoliosis or may contribute to the progression of scoliosis.By comparing patients in the scoliosis group with those in the lumbar spinal stenosis group,it was found that the overall muscle mass in the scoliosis group was significantly reduced,with the most significant reduction in the mass of the psoas major and multifidus muscles and no significant change in the muscle mass of the erector spinae;and the fat infiltration rate of the paravertebral muscles increased significantly in the scoliosis group,with the most significant increase in the multifidus and erector spinae muscles,and no significant difference was seen between the two groups in the fat infiltration rate of the psoas major muscle,which was related to the location of the muscle. |
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