Paravertebral muscle degeneration affects coronal balance in patients with degenerative lumbar scoliosis

Han Quan; Liang Chengzhen; Chen Qixin; Shen Yuanqing; Li Fangcai

doi:10.1016/j.wneu.2024.123644

Paravertebral muscle degeneration affects coronal balance in patients with degenerative lumbar scoliosis

World Neurosurg. 2025 Jan 3:123644. doi: 10.1016/j.wneu.2024.123644. Online ahead of print.

Authors

Han Quan¹, Liang Chengzhen¹, Chen Qixin¹, Shen Yuanqing², Li Fangcai³

Affiliations

¹ School of Medicine, Zhejiang University, 866 Yuhangtang Rd, Hangzhou 310058, P.R. China; Orthopaedics Center, the Second Affiliated Hospital Zhejiang University School of Medicine, 1511 Jianghong Rd, Hangzho 310014, P.R. China.
² Orthopaedics Center, the Second Affiliated Hospital Zhejiang University School of Medicine, 1511 Jianghong Rd, Hangzho 310014, P.R. China.
³ School of Medicine, Zhejiang University, 866 Yuhangtang Rd, Hangzhou 310058, P.R. China; Orthopaedics Center, the Second Affiliated Hospital Zhejiang University School of Medicine, 1511 Jianghong Rd, Hangzho 310014, P.R. China. Electronic address: 2505004@zju.edu.cn.

PMID: 39756542
DOI: 10.1016/j.wneu.2024.123644

Abstract

Purpose: This study aimed to investigate the impact of paraspinal muscle (PSM) degeneration on coronal balance in patients with degenerative lumbar scoliosis (DLS) METHODS: In this retrospective cross-sectional study, 127 DLS patients who underwent spinal fusion surgery were reviewed. Preoperative X-rays and MRIs were used to assess PSM degeneration, measured by the cross-sectional area (CSA) and fat infiltration rate (FIR) of the multifidus (MF) and erector spinae (ES) muscles. The ratios of the convex to concave sides, namely RCSA and RFIR, were calculated. Coronal balance was classified into types A, B, and C based on the coronal balance distance (CBD). One-way ANOVA and multiple logistic regression were performed to analyze PSM parameters and risk factors for imbalance.

Results: Significant differences were found among the coronal balance types in the RFIR of MF (p=0.009), RCSA of ES (p<0.001), FIR of ES (p=0.017), and RFIR of ES (p=0.001). Multiple logistic regression identified the RCSA and RFIR of ES as significant for type B imbalance, while the RFIR of MF and FIR of ES were significant for type C.

Conclusion: PSM degeneration, particularly in the MF and ES muscles, significantly affects coronal balance in DLS patients. Preoperative evaluation of these factors is essential for optimizing surgical outcomes.

Keywords: Asymmetric degeneration; Coronal Balance; Degenerative lumbar scoliosis; Paravertebral muscle degeneration; Sarcopenia.