Advances in research of paravertebral muscles of the lumbar spine

doi:10.3877/cma.j.issn.1674-0785.2024.09.008

Abstract

Abstract:

Lumbar paravertebral muscles， which play an important role in stabilizing the spine，have been observed to exhibit an increase in fat infiltration with age and lumbar degeneration. Magnetic resonance imaging （MRI） has emerged as a valuable tool for studying the morphology of paravertebral muscles and the degree of fat infiltration. A variety of measurement methods have been proposed by scholars for evaluating paravertebral muscles， including semi-quantitative （Goutallier grading system）， quantitative（muscle fat index MFI）， and functional evaluations （Ito test）. All of these methods have been demonstrated to have good reliability. Paravertebral muscle atrophy has been demonstrated to be associated with chronic low back pain， exhibiting a significant correlation with lumbar degenerative diseases such as lumbar disc herniation and lumbar spondylolisthesis. Additionally， it has been linked to osteoporosis and the number of spinal fractures. Furthermore， imaging studies have demonstrated that paravertebral muscle atrophy is associated with disc degeneration， endplate abnormalities， increased disc vacuum sign， increased osteoarthritis of the facet joints， decreased lumbar lordosis， and increased pelvic tilt. The surgical prognosis of patients is affected by alterations in paravertebral muscles. The fat infiltration index of paraspinal muscles correlates with poorer Oswestry Disability Index scores in postoperative patients. Furthermore， it is an independent risk factor for severe cage subsidence in men， an independent risk factor for postoperative proximal junctional kyphosis （PJK） in adult spinal deformities， and a potential risk factor for the occurrence of re-fracture after vertebroplasty and residual low back pain. A gene expression profiling study of paravertebral muscles revealed that increased COL3A1 expression was associated with a reduction in the fat infiltration in these muscles， while decreased mTOR expression was associated with an increase in the functional cross-sectional area of paravertebral muscles.

Key words: Paravertebral muscles, Magnetic resonance imaging, Lumbar degenerative diseases, Clinical outcome

Jingming Wang, Lei Wang, Xiaoduo Xu, Wenqiang Xing, Zhaoyan Zhang, Weimin Huang. Advances in research of paravertebral muscles of the lumbar spine[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(09): 846-852.

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