• Hyo Sub Jun, Ji Hee Kim, Jun Hyong Ahn, In Bok Chang, Joon Ho Song, Tae Hwan Kim, Moon Soo Park, Chan Kim Yong Y, Seok Woo Kim, Jae Keun Oh, and Yoon Do Heum DH.
• Departments of ‡Neurosurgery and §Orthopedics, Hallym University Sacred Heart Hospital, Anyang, Korea; ¶Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
• Neurosurgery. 2016 Dec 1; 79 (6): 847-855.

BackgroundThe majority of earlier studies of the parameters of sagittal balance did not consider the influence of spinal muscles on spinal sagittal alignment.ObjectiveTo analyze the relationship between the paraspinal muscle (quantity and quality) and sagittal alignment in elderly patients.MethodsWe reviewed 50 full-spine lateral standing radiographs and lumbar magnetic resonance images of elderly patients at a single center. The radiographic parameters examined were thoracic kyphosis, lumbar lordosis (LL), sagittal vertical axis, pelvic tilt, sacral slope, and pelvic incidence (PI). The lumbar muscularity (LM; quantity) and fatty degeneration ratio (FD; quality) in the paraspinal muscle were measured at the L3 level on magnetic resonance images. The relationships between the parameters, LM, and FD were analyzed with the Pearson correlation coefficient and multiple linear regression.ResultsPearson analysis demonstrated that the FD had significant correlations with age (r = 0.393), thoracic kyphosis (r = -0.559), pelvic tilt (r = 0.430), sagittal vertical axis (r = 0.488), and PI - LL (r = 0.479, P < .05), and a close negative correlation was found between the FD and LL (r = -0.505, P < .01). The LM had significant correlations with the LL (r = 0.342) and PI - LL (r = -0.283, P < .05). Regression models that controlled for confounding factors such as body mass index confirmed the correlations between the above parameters and FD (P < .05).ConclusionThe quality of the paraspinal muscle could be one of the various factors that influence sagittal balance.AbbreviationsBMI, body mass indexCSA, cross-sectional areaFD, fatty degeneration ratioLL, lumbar lordosisLM, lumbar muscularityPI, pelvic incidencePT, pelvic tiltSC, subcutaneous fatSS, sacral slopeSVA, sagittal vertical axisTK, thoracic kyphosisVB, vertebral body.

22 keywords...

hide…