• Eur Spine J · Oct 2022

    The effect of age on psoas and paraspinal muscle morphology in patients undergoing posterior lumbar fusion surgery.

    • Maximilian Muellner, Erika Chiapparelli, Manuel Moser, Henryk Haffer, Yusuke Dodo, Dominik Adl Amini, John A Carrino, Ek T Tan, Jennifer Shue, Jiaqi Zhu, Andrew A Sama, Frank P Cammisa, Federico P Girardi, and Alexander P Hughes.
    • Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th Street, New York, NY, 10021, USA.
    • Eur Spine J. 2022 Oct 1; 31 (10): 261926282619-2628.

    PurposeThe aim of this study was to determine the effect of age on the psoas and posterior paraspinal muscles (PPM; multifidus muscle and erector spinae) and to evaluate potential sex-related differences.MethodsMRI-based quantitative assessments of the cross-sectional area (CSA), the functional cross-sectional area (fCSA), the fat area (FAT) and the proportion of intramuscular fat (FI) were conducted on patients undergoing lumbar fusion surgery between 2014 and 2021. The regions of interest were the psoas muscle and the PPM at the superior endplate of L4. The left and right sides of the muscle groups were summarized and normalized by the patient's height (cm2/m2). The relationships between age and muscular parameters were analyzed stratified by sex.ResultsA total of 195 patients (57.9%female) with a median age of 64.2 years and a body mass index of 28.3 kg/m2 were analyzed. The CSAPsoas was 7.7 cm2/m2 and differed significantly between females and males (p < 0.001); likewise, the fCSAPsoas differed significantly between the sexes. The CSAPPM was 18.8 cm2/m2 with no sex-specific differences. Significant differences were found in the FIPPM (males: 41.1% vs. females: 47.9%; p < 0.001), but not in the FIPsoas (males: 3.7% vs. females: 4.5%; p = 0.276). Considering the effect of age on FI, a significant positive correlation was observed for the PPMs for both sexes. Only in women, there was a negative correlation between age and CSAPsoas (ρ =  - 0.248; p = 0.008), FATPsoas (ρ =  - 0.421; p < 0.001) and FIPsoas (ρ =  - 0.371; p < 0.001).ConclusionThis study demonstrated sex-specific differences in spinal muscle morphology in relation to patient age. With increasing age there was a decrease in FIPsoas in women only, unlike in the PPMs in which there was increased FI that was significantly higher in women compared to men.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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