Influence of paravertebral muscles on spinopelvic sagittal plane in patients with isthmic spondylolisthesis: an evaluation of muscle quantity and quality

doi:10.12307/2025.148

Abstract

Abstract: BACKGROUND: Cross-sectional area and fat infiltration are the standard parameters for quantifying paravertebral muscle, but it is too cumbersome and time-consuming to introduce new quantifying indicators.
OBJECTIVE: To investigate the relationship between paravertebral muscle and spinopelvic sagittal parameters and the predictive value of lumbar indentation value for sagittal balance in patients with isthmic spondylolisthesis.
METHODS: The study included 87 patients diagnosed with spondylolisthesis, all of whom had grade II spondylolisthesis according to Meyerding classification, including 40 males and 47 females, with a mean age of (51.4±9.1) years. The sagittal vertical axis, pelvic incidence angle, pelvic inclination angle, sacral inclination angle, lumbar lordosis, thoracic kyphosis, and the difference between pelvic incidence and lumbar lordosis were measured. The total cross-sectional area, functional cross-sectional area, and fat infiltration of lumbar paracolateral muscles were measured. Pearson correlation analysis was used to investigate the correlation between sagittal parameters and paravertebral muscle measurements. Multiple linear regression was used to analyze the effects of lumbar indentation value, age, sex, and body mass index on spinopelvic sagittal balance. The receiver operating characteristic curve was used to find the best cut-off point of the indentation value of the lumbar spine, and the relationship of sagittal vertical axis and pelvic incidence with lumbar lordosis was evaluated.
RESULTS AND CONCLUSION: (1) According to Pearson correlation analysis, the total cross-sectional area of the multifidus muscle was significantly correlated with lumbar lordosis (r=0.464, P < 0.01) and the difference between pelvic incidence and lumbar lordosis (r=-0.306, P < 0.01). The functional cross-sectional area of multifidus muscle was significantly correlated with lumbar lordosis (r=0.367, P < 0.01) and the difference between pelvic incidence and lumbar lordosis (r=-0.228, P < 0.05). The indentation value of lumbar spine was significantly correlated with the sagittal vertical axis (r=-0.300, P < 0.01), lumbar lordosis (P=0.417, P < 0.01), thoracic kyphosis (r=0.351, P < 0.01), and the difference between pelvic incidence and lumbar lordosis (r=-0.319, P < 0.01). (2) According to multiple linear regression analysis, the indentation value of lumbar spine was independently correlated with the difference between pelvic incidence and lumbar lordosis and the sagittal vertical axis. 55% (11/20) of patients with lumbar indentation value ≤11.5 mm had sagittal vertical axis ≤ 50 mm, while 96% (64/67) of patients with lumbar indentation value > 11.5 mm had sagittal vertical axis ≤ 50 mm. 30% (6/20) of patients with the difference between pelvic incidence and lumbar lordosis ≤ 11.5 mm had the difference between pelvic incidence and lumbar lordosis ≤ 10°, while 66% (44/67) of patients with lumbar indentation value > 11.5 mm had the difference between pelvic incidence and lumbar lordosis ≤ 10°. (3) It is concluded that both total cross-sectional area and functional cross-sectional area were significantly correlated with lumbar lordosis and the difference between pelvic incidence and lumbar lordosis. Lumbar indentation value, as a new indicator for the evaluation of paravertebral degeneration, was independently correlated with the sagittal vertical axis and the difference between pelvic incidence and lumbar lordosis, and had certain predictive value for postoperative sagittal plane correction. It was a simple and practical method for the evaluation of spinopelvic sagittal plane and paravertebral muscle degeneration. The degeneration of the paravertebral muscle is related to spinopelvic sagittal balance.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: isthmic spondylolisthesis, cross-sectional area, lumbar indentation value, spinopelvic sagittal parameter, paravertebral muscle, fat infiltration

CLC Number:

Song Hanlin, Hu Tianyu, Gao Haoran, Shi Yaozhou, Gao Xiao, Feng Hu. Influence of paravertebral muscles on spinopelvic sagittal plane in patients with isthmic spondylolisthesis: an evaluation of muscle quantity and quality[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(21): 4445-4451.

Figures/Tables 4

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