• Spine · Feb 2025

    Quantitative Analysis of Relationship between Paraspinal Muscle Degeneration and Degree of Degenerative Lumbar Spondylolisthesis.

    • Weiwei Da, Qiang Jian, Joiner Evan, Andrew K Chan, Paul C McCormick, Christopher E Mandigo, Justin Anthony Neira, Peter D Angevine, Xiaofeng Li, and Dean Chou.
    • Department of Neurological Surgery, New York Presbyterian-Columbia University, New York, USA, 10034.
    • Spine. 2025 Feb 3.

    Study DesignClinical retrospective study.ObjectiveThe authors aim to analyze the relationship between paraspinal muscle degeneration and degree of L4-5 Degenerative lumbar spondylolisthesis (DLS).Summary Of Background DataWhile paraspinal muscle degeneration is thought to contribute to spondylolisthesis severity, this relationship has yet to be fully characterized.MethodsA retrospective analysis was performed of all neurosurgical patients admitted to the Columbia Neurosurgery Spine Division for treatment of L4-5 DLS between January 2018 and March 2024. Preoperative lumbopelvic parameters and slip percentage (SP) were calculated from standing radiographs; paraspinal muscle volume (MV), fatty volume (FV) and fatty infiltration (FI) of posterior paraspinal muscle were derived from MRI images using 3D Slicer (Earth, TX). Correlation and multiple linear regression analyses were used to assess the relationship between SP and paraspinal MV, FV, FI, and spinopelvic parameters.Results221 patients with average SP of 23.74±0.09% were included. The female patients had higher SP, lumbar lordosis (LL), pelvic incidence (PI) and lower IVA than the male patients. However, paraspinal MV was lower and FI was higher in the Meyerding Grade II and female groups compared to the Grade I and male groups (P<0.01). There was a positive correlation between SP and metrics of fat replacement (P<0.01) and a negative correlation between SP and metrics of paraspinal muscles volume (P<0.01) at the L4-5 level. A stepwise multivariate regression ultimately included MFI, IVA, and LL and accounted for 15.2% of the variance in SP.ConclusionIn this single center retrospective study, greater degree of spondylolisthesis was modestly associated with lower MV and increased FI of the lumbar paraspinal muscles, suggesting that paraspinal muscle degeneration may be one of several important factors in the development of spondylolisthesis.Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

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