Study On The Correlation Between Fat Infiltration In Cervical Paraspinal Muscles And Cervical Curvature And Neck Pain

Objective Weakness of cervical paraspinal muscles causes loss of cervical lordosis,which could cause neck pain.MRI examination has the advantages of noninvasive and sensitive,and has high resolution of soft tissue.Multiple studies have demonstrated that the IDEAL-IQ sequence,a new MRI technique,can accurately measure muscle fat fraction.The purpose of this study was to measure the correlation between cervical paraspinal muscle fat fraction and cervical curvature and neck pain using the new MRI technique.Methods Outpatients with neck pain for more than 3 months from January 2019 to December 2019 were collected.All of these patients received anterior and lateral radiographs of the cervical spine and MRI of the cervical spine.Cervical MRI included routine sequence and IDEAL-IQ sequence.We need to record the patient’s age,height and weight.The IDEAL-IQ sequence was used to measure the fat fraction of the cervical paraspinal muscle in the upper(C2-3 disc center level)and lower(C6-7 disc center level)neck of each patient.We needed to observe the cervical disc degeneration grade in T2WI sagittal position,measure the cervical Cobb Angle of each patient in PACS,and perform the digital grading method(NRS)pain score and the neck dysfunction index(NDI)clinical score.SPSS 24.00 statistical software was used for statistical analysis,and the correlation between the cervical paraspinal muscle fat fraction and age,BMI,disc degeneration grade,cervical Cobb Angle and clinical score were analyzed.Results The median cervical Cobb Angle is 22(17,25).The median grade of intervertebral disc degeneration is 3(2.4,3.4).Clinical scores showed that the median NRS score is 3(2,4),and the median NDI index is 24(20,26).Median paraspinal muscle fat fraction at C2-3 intervertebral disc level was 13.15(11.04,16.91).Median paraspinal muscle fat fraction at the C6-7 intervertebral disc level was 14.60(11.29,17.94).Fat fraction in cervical paraspinal muscles was positively correlated with NRS scores at both levels(C2-3,p<0.001.C6-7,p<0.001).At the C2-3 intervertebral level,the cervical paraspinal muscle fat fraction was negatively correlated with cervical Cobb Angle(r=-0.294,p=0.010).At the C6-7 intervertebral level,fat infiltration in the cervical paraspinal muscles was closely related to NDI(r=0.475,p<0.001).There was no significant correlation between cervical paraspinal muscle fat fraction and age,BMI and disc degeneration grade at the C2-3 intervertebral level(P>0.05).There was no significant correlation between cervical paraspinal muscle fat fraction and BMI,disc degeneration grade at the C6-7 intervertebral level(P>0.05).At the C6-7 paraspinal level,the cervical paraspinal muscle fat fraction was negatively correlated with age(r=0.324,p=0.005).However,there was no significant correlation between cervical curvature and clinical outcomes(p＞0.05).Conclusions Increased fat infiltration in the cervical paraspinal muscles was significantly associated with higher neck pain.These results suggested that fat infiltration in the upper cervical paraspinal muscles has relevance to the loss of normal curvature of the cervical spine,whereas fat infiltration in the lower cervical paraspinal muscles may be associated with partial loss of cervical function.