• Gaston Camino-Willhuber, Lukas Schönnagel, Erika Chiapparelli, Krizia Amoroso, Soji Tani, Thomas Caffard, Artine Arzani, Ali E Guven, Bruno Verna, Jiaqi Zhu, Jennifer Shue, William D Zelenty, Gbolabo Sokunbi, Mariana Bendersky, Federico P Girardi, Andrew A Sama, Frank P Cammisa, and Alexander P Hughes.
• Department of Orthopaedic Surgery, Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 E 70th St, New York City, NY, 10021, USA.
• Eur Spine J. 2024 Mar 1; 33 (3): 101310201013-1020.

PurposeIntervertebral vacuum phenomenon (IVP) and paraspinal muscular atrophy are age-related changes in the lumbar spine. The relationship between both parameters has not been investigated. We aimed to analyze the correlation between IVP and paraspinal muscular atrophy in addition to describing the lumbar vacuum severity (LVS) scale, a new parameter to estimate lumbar degeneration.MethodsWe analyzed patients undergoing spine surgery between 2014 and 2016. IVP severity was assessed utilizing CT scans. The combination of vacuum severity on each lumbar level was used to define the LVS scale, which was classified into mild, moderate and severe. MRIs were used to evaluate paraspinal muscular fatty infiltration of the multifidus and erector spinae. The association of fatty infiltration with the severity of IVP at each lumbar level was assessed with a univariable and multivariable ordinal regression model.ResultsTwo hundred and sixty-seven patients were included in our study (128 females and 139 males) with a mean age of 62.6 years (55.1-71.2). Multivariate analysis adjusted for age, BMI and sex showed positive correlations between LVS-scale severity and fatty infiltration in the multifidus and erector spinae, whereas no correlation was observed in the psoas muscle.ConclusionIVP severity is positively correlated with paraspinal muscular fatty infiltration. This correlation was stronger for the multifidus than the erector spinae. No correlations were observed in the psoas muscle. The lumbar vacuum severity scale was significantly correlated with advanced disc degeneration with vacuum phenomenon.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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