nach oben

Skeletal Radiology

Erschienen in:

29.01.2018 | Scientific Article

Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients

verfasst von: Julio Urrutia, Pablo Besa, Daniel Lobos, Mauricio Campos, Cristobal Arrieta, Marcelo Andia, Sergio Uribe

Erschienen in: Skeletal Radiology | Ausgabe 7/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To determine the association of paraspinal muscles and psoas relative cross-sectional area (RCSA) and fat signal fraction (FSF) with sex, age, and intervertebral disc degeneration (IDD) in symptomatic patients.

Methods

We retrospectively evaluated 80 adult patients with spinal symptoms using T2-weighted magnetic resonance images. We determined RCSA and FSF of the paraspinal muscles (erector spinae and multifidus) and psoas from L1–L2 to L5–S1; we determined IDD using the Pfirrmann classification. We compared differences in muscle RCSA and FSF based on sex and IDD, and we correlated age and IDD with RCSA and FSF. Using multivariate linear regression analyses, we determined the impact of sex, age, and IDD on RCSA and FSF.

Results

Men exhibited larger psoas RCSA but not larger paraspinal muscles RCSA than women. Women had larger FSF in the paraspinal muscles and psoas. Increasing IDD was associated with larger FSF if ≥2 Pfirrmann grades were observed. IDD correlated with FSF of the paraspinal muscles, and age correlated with FSF of the paraspinal muscles and psoas. IDD was less consistently correlated with RCSA, but age correlated negatively with RCSA of all three muscles. Linear regression analyses demonstrated that sex, age, and IDD were each independently associated with FSF of the paraspinal muscles; additionally, sex and age, but not IDD, were associated with psoas FSF. RCSA was less consistently influenced by these three variables.

Conclusions

Sex, age, and IDD are independently associated with paraspinal muscles FSF; only sex and age influence psoas FSF.

Ploumis A, Michailidis N, Christodoulou P, Kalaitzoglou I, Gouvas G, Beris A. Ipsilateral atrophy of paraspinal and psoas muscle in unilateral back pain patients with monosegmental degenerative disc disease. Br J Radiol. 2011;84:709–13. https://doi.org/10.1259/bjr/58136533.CrossRefPubMedPubMedCentral

Parkkola R, Rytokoski U, Kormano M. Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects. Spine (Phila Pa 1976). 1993;18:830–6.CrossRef

Fortin M, Lazary A, Varga PP, Battie MC. Association between paraspinal muscle morphology, clinical symptoms and functional status in patients with lumbar spinal stenosis. Eur Spine J. 2017;26:2543–51. https://doi.org/10.1007/s00586-017-5228-y.CrossRefPubMed

Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf-Yde C. Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? BMC Med. 2007;5:2. https://doi.org/10.1186/1741-7015-5-2.CrossRefPubMedPubMedCentral

Mengiardi B, Schmid MR, Boos N, Pfirrmann CW, Brunner F, Elfering A, et al. Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy. Radiology. 2006;240:786–92. https://doi.org/10.1148/radiol.2403050820.CrossRefPubMed

Hides J, Gilmore C, Stanton W, Bohlscheid E. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther. 2008;13:43–9. https://doi.org/10.1016/j.math.2006.07.017.CrossRefPubMed

Barry JJ, Lansdown DA, Cheung S, Feeley BT, Ma CB. The relationship between tear severity, fatty infiltration, and muscle atrophy in the supraspinatus. J Shoulder Elb Surg. 2013;22:18–25. https://doi.org/10.1016/j.jse.2011.12.014.CrossRef

Hodges P, Holm AK, Hansson T, Holm S. Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine (Phila Pa 1976). 2006;31:2926–33. https://doi.org/10.1097/01.brs.0000248453.51165.0b.CrossRef

Hodges PW, James G, Blomster L, Hall L, Schmid A, Shu C, et al. Multifidus muscle changes after back injury are characterized by structural remodeling of muscle, adipose and connective tissue, but not muscle atrophy: molecular and morphological evidence. Spine (Phila Pa 1976). 2015;40:1057–71. https://doi.org/10.1097/BRS.0000000000000972.CrossRef

10.

Kalichman L, Hodges P, Li L, Guermazi A, Hunter DJ. Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study. Eur Spine J. 2010;19:1136–44. https://doi.org/10.1007/s00586-009-1257-5.CrossRefPubMed

11.

Kalichman L, Klindukhov A, Li L, Linov L. Indices of Paraspinal muscles degeneration: reliability and association with facet joint osteoarthritis: feasibility study. Clin Spine Surg. 2016;29:465–70. https://doi.org/10.1097/BSD.0b013e31828be943.CrossRefPubMed

12.

Sebro R, O'Brien L, Torriani M, Bredella MA. Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine. Skelet Radiol. 2016;45:1221–6. https://doi.org/10.1007/s00256-016-2405-8.CrossRef

13.

Teichtahl AJ, Urquhart DM, Wang Y, Wluka AE, Wijethilake P, O'Sullivan R, et al. Fat infiltration of paraspinal muscles is associated with low back pain, disability, and structural abnormalities in community-based adults. Spine J. 2015;15:1593–601. https://doi.org/10.1016/j.spinee.2015.03.039.CrossRefPubMed

14.

Shahidi B, Parra CL, Berry DB, Hubbard JC, Gombatto S, Zlomislic V, et al. Contribution of lumbar spine pathology and age to paraspinal muscle size and fatty infiltration. Spine (Phila Pa 1976). 2017;42:616–23. https://doi.org/10.1097/BRS.0000000000001848.CrossRef

15.

Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001;26:1873–8.CrossRef

16.

Urrutia J, Besa P, Campos M, Cikutovic P, Cabezon M, Molina M, et al. The Pfirrmann classification of lumbar intervertebral disc degeneration: an independent inter- and intra-observer agreement assessment. Eur Spine J. 2016;25:2728–33. https://doi.org/10.1007/s00586-016-4438-z.CrossRefPubMed

17.

Crawford RJ, Filli L, Elliott JM, Nanz D, Fischer MA, Marcon M, et al. Age- and level-dependence of fatty infiltration in lumbar paravertebral muscles of healthy volunteers. AJNR Am J Neuroradiol. 2016;37:742–8. https://doi.org/10.3174/ajnr.A4596.CrossRefPubMed

18.

Lee SH, Park SW, Kim YB, Nam TK, Lee YS. The fatty degeneration of lumbar paraspinal muscles on computed tomography scan according to age and disc level. Spine J. 2017;17:81–7. https://doi.org/10.1016/j.spinee.2016.08.001.CrossRefPubMed

19.

Fortin M, Battie MC. Quantitative paraspinal muscle measurements: inter-software reliability and agreement using OsiriX and ImageJ. Phys Ther. 2012;92:853–64. https://doi.org/10.2522/ptj.20110380.CrossRefPubMed

20.

Crawford RJ, Cornwall J, Abbott R, Elliott JM. Manually defining regions of interest when quantifying paravertebral muscles fatty infiltration from axial magnetic resonance imaging: a proposed method for the lumbar spine with anatomical cross-reference. BMC Musculoskelet Disord. 2017;18:25. https://doi.org/10.1186/s12891-016-1378-z.CrossRefPubMedPubMedCentral

21.

Hyun SJ, Bae CW, Lee SH, Rhim SC. Fatty degeneration of the paraspinal muscle in patients with degenerative lumbar kyphosis: a new evaluation method of quantitative digital analysis using MRI and CT scan. Clin Spine Surg. 2016;29:441–7. https://doi.org/10.1097/BSD.0b013e3182aa28b0.CrossRefPubMed

22.

Otsu N. A threshold selection method from gray-level histograms. IEEE Trans Syst, Man, Cybernet: Syst. 1979;9:62–6.CrossRef

23.

Song Y, Zhu LA, Wang SL, Leng L, Bucala R, Lu LJ. Multi-dimensional health assessment questionnaire in China: reliability, validity and clinical value in patients with rheumatoid arthritis. PLoS One. 2014;9:e97952. https://doi.org/10.1371/journal.pone.0097952.CrossRefPubMedPubMedCentral

24.

Kader DF, Wardlaw D, Smith FW. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol. 2000;55:145–9. https://doi.org/10.1053/crad.1999.0340.CrossRefPubMed

25.

Fortin M, Videman T, Gibbons LE, Battie MC. Paraspinal muscle morphology and composition: a 15-yr longitudinal magnetic resonance imaging study. Med Sci Sports Exerc. 2014;46:893–901. https://doi.org/10.1249/MSS.0000000000000179.CrossRefPubMed

26.

Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine (Phila Pa 1976). 2004;29:E515–9.CrossRef

27.

Stokes MJ, Cooper RG, Morris G, Jayson MI. Selective changes in multifidus dimensions in patients with chronic low back pain. Eur Spine J. 1992;1:38–42.CrossRefPubMed

28.

Ranson CA, Burnett AF, Kerslake R, Batt ME, O'Sullivan PB. An investigation into the use of MR imaging to determine the functional cross-sectional area of lumbar paraspinal muscles. Eur Spine J. 2006;15:764–73. https://doi.org/10.1007/s00586-005-0909-3.CrossRefPubMed

29.

Hicks GE, Simonsick EM, Harris TB, Newman AB, Weiner DK, Nevitt MA, et al. Cross-sectional associations between trunk muscle composition, back pain, and physical function in the health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2005;60:882–7.CrossRefPubMed

30.

D'Hooge R, Cagnie B, Crombez G, Vanderstraeten G, Dolphens M, Danneels L. Increased intramuscular fatty infiltration without differences in lumbar muscle cross-sectional area during remission of unilateral recurrent low back pain. Man Ther. 2012;17:584–8. https://doi.org/10.1016/j.math.2012.06.007.CrossRefPubMed

31.

Fortin M, Lazary A, Varga PP, McCall I, Battie MC. Paraspinal muscle asymmetry and fat infiltration in patients with symptomatic disc herniation. Eur Spine J. 2016;25:1452–9. https://doi.org/10.1007/s00586-016-4503-7.CrossRefPubMed

32.

Crawford RJ, Elliott JM, Volken T. Change in fatty infiltration of lumbar multifidus, erector spinae, and psoas muscles in asymptomatic adults of Asian or Caucasian ethnicities. Eur Spine J. 2017; https://doi.org/10.1007/s00586-017-5212-6.

33.

Fischer MA, Nanz D, Shimakawa A, Schirmer T, Guggenberger R, Chhabra A, et al. Quantification of muscle fat in patients with low back pain: comparison of multi-echo MR imaging with single-voxel MR spectroscopy. Radiology. 2013;266:555–63. https://doi.org/10.1148/radiol.12120399.CrossRefPubMed

Titel: Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients
verfasst von: Julio Urrutia
Pablo Besa
Daniel Lobos
Mauricio Campos
Cristobal Arrieta
Marcelo Andia
Sergio Uribe
Publikationsdatum: 29.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Skeletal Radiology / Ausgabe 7/2018
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-018-2880-1

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients