The Correlation Between Degree Of Multifidus Muscle Atrophy And Degree Of Lumbar Slip In Degenerative Lumbar Spondylolisthesis Patients

Objective To analyze the difference between the degree of multifid muscle atrophy of degenerative lumbar spondylolisthesis and that of non-spondylolisthesis,and the correlation between the degree of multifid muscle atrophy of degenerative lumbar spondylolisthesis and the degree of lumbar spondylolisthesis.Methods A total of 103 patients with lumbar degenerative spondylolisthesis were retrospectively analyzed,from January 2008 to April 2019,including 22 male patients(21.4%)and 81 female patients(78.6%).Including 2 cases of L2 spondylolisthesis,10 cases of L3 spondylolisthesis,81 cases of L4 spondylolisthesis,10 cases of L5 spondylolisthesis.The average age was 58.55 10.88 years old with the age ranging from 37 to 77 years old.Each patient underwent lumbar lateral X-ray,lumbar MRI and other imaging data,and the imaging data were collected.The data were measured by Image-Pro Plus.The lumbar spondylolisthesis ratio of each patient was measured on the lateral X-ray of the lumbar spine.MRI images were obtained to measure and calculate the ratio of the fat-free multifidus muscle cross sectional area to total multifidus muscle cross sectional area(FCSA/TCSA)in slipped segment and non-slipped segments.The total multifidus muscle cross sectional area(TCSA)of the degenerative spondylolisthesis and the fat-free multifidus muscle cross sectional area(FCSA)of each patient were measured on MRI,and the ratio of FCSA/TCSA was calculated to evaluate the degree of multifid muscle atrophy.The higher the value,the lighter the muscle atrophy.The total cross-sectional area(TCSA)and fat-free multifidus muscle cross sectional area(FCSA)in the previous non-spondylolisthesis segment were measured by the same method.All data were analyzed by SPSS 23.0.Check the consistency of the measured data of the two physicians.Paired-samples T test was carried out to investigate whether there were differences between LCSA/TCSA in slipped segment and LCSA/TCSA in non-slipped segment.The correlation between LCSA/TCSA in slipped segment and slipped ratio was analyzed by using Pearson correlation coefficient system.P<0.01 was considered statistically significant.Results According to the consistency test of the measurement results of the two physicians,the consistency test of the lumbar spondylolisthesis ratio data ICC=0.991>0.75)showed that the consistency of the measurement data of the two physicians was high,and the ICC value of degenerative segmental FCSA/TCSA data was 1>0.75,indicating that the measurement data of the two doctors had high consistency.The consistency test of normal segment FCSA/TCSA data,ICC value=0.999>0.75,indicating that the consistency of the data measured by the two physicians is high.The degree of multifid muscle atrophy(FCSA/TCSA)in the upper non-spondylolisthesis segment and the multifid muscle atrophy(FCSA/TCSA)in the degenerative spondylolisthesis segment were tested by paired sample t-test,t value was-12.618,P value was 0.00.there was significant difference between them(P<0.01).The degree of multifid muscle atrophy(FCSA/TCSA)of degenerative spondylolisthesis was correlated with the spondylolisthesis ratio,and the correlation coefficient was-0.425.There was a high negative correlation between FCSA/TCSA ratio and spondylolisthesis ratio of degenerative spondylolisthesis.Conclusion the degree of multifid muscle atrophy in degenerative spondylolisthesis is more serious than that in the upper non-spondylolisthesis segment,and there is a positive correlation between the degree of multifid muscle atrophy in degenerative lumbar spondylolisthesis and the degree of lumbar spondylolisthesis in degenerative lumbar spondylolisthesis patients.