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Correlation between posterior paraspinal muscle atrophy and lumbar intervertebral disc degeneration in patients with chronic low back pain

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Abstract

Background

Although enormous studies have been devoted to solving the problem of intervertebral disc degeneration/herniation, little attention is paid to the effect of paraspinal muscles on it. We aimed to investigate the correlation between paraspinal muscle atrophy and lumbar disc degeneration to recognize paraspinal muscle atrophy and its importance to the spine.

Patients and methods

A total of 107 patients were enrolled in the study (65 females, 42 males; age 50.87 ± 15.391 years old). Cross-sectional area, functional cross-sectional area, and fatty infiltration of the posterior paraspinal muscles were measured at the level of L4/5, and the degree of facet joint degeneration was evaluated at the levels of L3/4, L4/5, and L5/S1 by MRI. After controlling the confounding factors by multiple linear regression, the correlations among paraspinal muscle atrophy, disc degeneration, and facet joint degeneration were analyzed. Meanwhile, Pearson/Spearson rank analysis was used to analyze the correlation between clinical symptoms (VAS and ODI) and paraspinal muscle atrophy.

Results

There was a strong correlation between paraspinal muscle atrophy and disc degeneration after controlling the confounding factors (p < 0.05, R > 0.5). There was a weak correlation between paraspinal muscle atrophy and facet joint degeneration (p < 0.05, R < 0.5). There was a significant correlation between facet joint degeneration and intervertebral disc degeneration (p < 0.05, R > 0.7). The fatty infiltration of paraspinal muscle was weakly correlated with ODI (p < 0.05, R < 0.3), but VAS was not.

Conclusions

The degree of paraspinal muscle atrophy increased with lumbar disc degeneration and facet joint degeneration and fatty infiltration of multifidus was more susceptible to weight.

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Data availability

Any data of the patients included in the study are available if required.

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Acknowledgements

We would like to thank for the instructions from professor An Qin in Shanghai Ninth People’s Hospital.

Funding

The study received financial support from the Applied Basic Research Foundation of Guangdong Province (no. 2020A1515011388); Postdoctoral Research Foundation of China (no. 2021M703719); and Foundation of Nanchang high-level scientific and technological innovation talents (Hongkezi (2021) no. 156).

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Author notes

  1. Ziying Cheng and Yuxi Li contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Guangdong Province, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, China

    Ziying Cheng, Yuxi Li, Ming Li, Junshen Huang, Jiajun Huang, Yuwei Liang, Shixin Lu, Changchun Liang, Tong Xing, Kaihui Su, Guoming Wen & Lin Huang

  2. Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang Xi Road, Guangzhou, Guangdong Province, China

    Weike Zeng

  3. Department of Orthopedics, First Hospital of Nanchang, Nanchang, Jiangxi Province, China

    Lin Huang

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  1. Ziying Cheng
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  3. Ming Li
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Ziying Cheng, Yuxi Li, Ming Li, Junshen Huang, Jiajun Huang, Yuwei Liang, Shixin Lu, Changchun Liang, Tong Xing, Kaihui Su, and Guoming Wen. Ziying Cheng, Yuxi Li, Weike Zeng, and Lin Huang drafted of the manuscript. All the authors read and approved the final manuscript.

Corresponding authors

Correspondence to Weike Zeng or Lin Huang.

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Ethics approval and consent to participate

Participants were recruited from orthopedic and radiology outpatients, and the information we needed to conduct the study via face-to-face. Written consent was obtained before the examination of all participants.

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The authors declare no competing interests.

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Cheng, Z., Li, Y., Li, M. et al. Correlation between posterior paraspinal muscle atrophy and lumbar intervertebral disc degeneration in patients with chronic low back pain. International Orthopaedics (SICOT) 47, 793–801 (2023). https://doi.org/10.1007/s00264-022-05621-9

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