Abstract：
Lumbar spine disorders often cause lower back pain, lower limb radiating pain, restricted movement, and neurological dysfunction, which seriously affect the quality of life of middle-aged and older people. It has been found that pathological changes in the spine often cause changes in the morphology and function of the paraspinal muscles (PSMs). Fatty infiltration (FI) in PSMs is closely associated with disc degeneration and Modic changes. And FI causes inflammatory responses that exacerbate the progression of lumbar spine disease and disrupt postoperative recovery. Magnetic resonance imaging can better distinguish between fat and muscle tissue with the threshold technique. Three-dimensional magnetic resonance imaging multi-echo imaging techniques such as water-fat separation and proton density are currently popular for studying FI. Muscle fat content obtained based on these imaging sequences has greater accuracy, visualization, acquisition speed, and utility. The proton density fat fraction calculated from these techniques has been shown to evaluate more subtle changes in PSMs. Magnetic resonance spectroscopy can accurately reflect the relationship between FI and the degeneration of PSMs by measuring intracellular and extracellular lipid values to quantify muscle fat. We have pooled and analyzed published studies and found that patients with spinal disorders often exhibit FI in PSMs. Some studies suggest an association between FI and adverse surgical outcomes, although conflicting results exist. These suggest that clinicians should consider FI when assessing surgical risks and outcomes. Future studies should focus on understanding the biological mechanisms underlying FI and its predictive value in spinal surgery, providing valuable insights for clinical decision-making.
摘要：
腰椎疾患常引起下背部疼痛，下肢放射痛，限制移动,和神经功能障碍，严重影响中老年人的生活质量。已经发现，脊柱的病理变化通常会导致椎旁肌肉（PSM）的形态和功能发生变化。PSM的脂肪浸润（FI）与椎间盘退变和Modic变化密切相关。FI会引起炎症反应，加剧腰椎疾病的进展并破坏术后恢复。磁共振成像(MRI)可以用阈值技巧更好地辨别脂肪和肌肉组织。目前，诸如水脂分离和质子密度之类的三维MRI多回波成像技术正在研究FI。基于这些成像序列获得的肌肉脂肪含量具有更高的准确性，可视化,采集速度,和效用。从这些技术计算的质子密度脂肪分数已被证明可以评估PSM的更微妙的变化。磁共振波谱可以通过测量细胞内和细胞外脂质值来量化肌肉脂肪，从而准确地反映FI与PSM变性之间的关系。我们汇总并分析了已发表的研究，发现脊柱疾病患者通常在PSM中表现出FI。一些研究表明FI与不良手术结局之间存在关联，尽管存在矛盾的结果。这些建议临床医生在评估手术风险和结果时应考虑FI。未来的研究应集中在了解FI的生物学机制及其在脊柱手术中的预测价值。为临床决策提供有价值的见解。
