OBJECTIVE: To explore the relationship between lumbar spine muscle mass and lumbar pelvic sagittal parameters in patients with degenerative scoliosis.
METHODS: This study included ADS patients who were treated in our hospital from 2019 to 2023. The spinal parameters were evaluated through X-rays, and the relative muscle volume (RMV) and fat infiltration (FI) were measured through three-dimensional reconstruction. Patients were categorized into 3 groups based on SRS-Schwab sagittal balance correction (0, +, ++), and into 3 groups based on GAP score (proportioned, moderately dis-proportioned, severely dis-proportioned). Finally, patients were classified into low-quality and high-quality groups based on the FI of Paraspinal muscles (PSM).
RESULTS: The study included a total of 63 patients. Significant statistical differences were observed in the FI and RMV of MF, ES and PS among patients classified by SRS-Schwab PT classification. Additionally, significant statistical differences were found in the RMV of MF and PS among patients classified by SRS-Schwab PI-LL classification and GAP score. Furthermore, a significant correlation was found between the FI and RMV of PSM and lumbopelvic sagittal parameters. The ordinal regression model analysis revealed that FI of ES significantly impacted PT imbalance, while RMV of MF significantly impacted PI-LL imbalance. Moreover, significant differences were noted in PT and PI between the low-quality and high-quality multifidus groups.
CONCLUSIONS: As sagittal imbalance worsens, PSM degeneration also intensifies, primarily characterized by an increase in FI and a decrease in RMV. Notably, PT and PI-LL are positively correlated with RMV and negatively correlated with FI.
目的:探讨退变性脊柱侧凸患者腰椎肌块与腰椎骨盆矢状面参数的关系。
方法:本研究纳入了2019年至2023年在我院接受治疗的ADS患者。通过X射线评估脊柱参数,通过三维重建测量相对肌肉体积(RMV)和脂肪浸润(FI)。根据SRS-Schwab矢状平衡校正将患者分为3组(0,+,++),并根据GAP得分分为3组(按比例,中等比例,严重失调)。最后,根据椎旁肌(PSM)FI将患者分为低质量和高质量组.
结果:本研究共纳入63例患者。MF的FI和RMV差异有统计学意义,通过SRS-SchwabPT分类的患者中的ES和PS。此外,在按SRS-SchwabPI-LL分类和GAP评分分类的患者中,MF和PS的RMV存在显着统计学差异。此外,PSM的FI和RMV与腰骨盆矢状参数之间存在显着相关性。有序回归模型分析显示,ES的FI显著影响PT失衡,而MF的RMV显著影响PI-LL失衡。此外,低质量和高质量多裂组的PT和PI存在显著差异.
结论:随着矢状失衡恶化,PSM退化也加剧,主要特征是FI增加和RMV减少。值得注意的是,PT和PI-LL与RMV呈正相关,与FI呈负相关。