Change in fatty infiltration of lumbar multifidus, erector spinae, and psoas muscles in asymptomatic adults of Asian or Caucasian ethnicities

  • Rebecca J. Crawford
  • James M. Elliott
  • Thomas Volken
Original Article
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Abstract

Purpose

Fatty infiltration (FI) is a feature of degenerating muscle that predominates in the low lumbar spine, associates with pain, and is confounded by age, spinal degeneration, and curvature. We determined rates for decline of lumbar muscle quality according to ethnicity, muscle, and spinal level in asymptomatic subjects.

Methods

Cross-sectional simulation study assessing aggregated data; 650 Asians aged 20–89 years versus 80 Caucasians aged 20–62 years. Change in lumbar multifidus, erector spinae (ES), and psoas fat content were computed using synthetic data and Monte Carlo simulations. General linear regression models and multivariate adaptive regression splines enabled estimation of yearly decline rates [with 95% confidence intervals (CI)].

Results

ES at L1–5 (total) shows steeply reduced density (rate; CI) for Asians in older (>53.3 years) adulthood (−0.32; −0.27 to −0.36/year). For Asians, multifidus (−0.18; −0.15 to −0.20/year) and psoas (−0.04; −0.03 to −0.06/year) also decline, while ES in younger ≤53.3 years) adults does not (0.06; 0.01–0.12/year). Caucasian multifidus declines (increasing FI % rate; CI) insignificantly faster (L1–5; 0.23; 0.10–0.36%/year) than ES (0.13; 0.04–0.22%/year). Multifidus decline does not differ between ethnicities. ES in older Asians generally declines fastest across ethnicities and muscles, and particularly in the low lumbar levels. Low lumbar levels show higher rates of decline in Asians, with mixed level-dependencies apparent in Caucasians.

Conclusions

Decline in lumbar muscle composition may differ between ethnicities and muscles. ES and low lumbar levels appear increasingly susceptible in Asians. Longitudinal studies examining rate of change to muscle composition may provide distinction between spinal conditions.

Keywords

Lumbar spine Multifidus Erector spinae Psoas Rate of change Fatty infiltration 

Abbreviations

APCT

Abdomen and pelvis computer tomography

CI

95% confidence intervals

ES

Erector spinae

FI

Fatty infiltration

LBP

Low back pain

MRI

Magnetic resonance imaging

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Institute for Health Sciences, School of Health ProfessionsZurich University of Applied SciencesWinterthurSwitzerland
  2. 2.Faculty of Health SciencesCurtin UniversityPerthAustralia
  3. 3.Department of Physical Therapy and Human Movement Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.School of Health and Rehabilitation SciencesUniversity of QueenslandBrisbaneAustralia

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