Volume of spinopelvic muscles: comparison between adult spinal deformity patients and asymptomatic subjects



Spinal muscles are a major component of posture in spinal pathologies and changes to the spine with aging. Specifically, spinopelvic muscles may compensate for underlying anomalies such as pelvic retroversion, knee flexion, and cervical or thoracic spinal balance abnormalities. To increase understanding between muscular characteristics and compensatory mechanisms, this study aimed to compare the volume of spinopelvic muscles in adults with a spinal deformity (ASD) to a control group of well-aligned adult subjects.


Twenty-eight lumbar ASD patients [Cobb angle > 20°, > 40 years old (yo)] were prospectively included and compared to 35 normal subjects divided into 2 different groups: one group of young (Y) subjects (n = 23, < 20 yo) and one group of old (O) subjects (n = 12, > 40 yo). All subjects had a fat/water separation MRI (from C7 to the knees). Volumetric 3D reconstructions of 30 spinopelvic muscles were performed and muscles volumes were compared.


Mean age was 60 ± 16 yo, without significant differences between the ASD and O groups (57 ± 11 yo). Age and BMI were smaller in the young group. Mean Cobb angle of the ASD group was 45 ± 11°. Comparing the ASD and O groups, total muscular volume was similar; however, erector spinae (0.24 ± 0.06 vs 0.68 ± 0.08 dm3, p = 0.001), iliopsoas (0.49 ± 0.09 vs 0.60 ± 0.09 dm3, p = 0.001) and obliquus (0.42 ± 0.08 vs 0.50 ± 0.08 dm3, p = 0.02) were significantly smaller in the ASD group. Comparing the Y and the ASD groups, total muscular volume was higher in the Y group than the ASD group (+ 3.3 dm3, p = 0.003) and erector spinae (0.24 ± 0.06 vs 0.74 ± 0.08, p = 0.0001), gluteus medius (0.51 ± 0.07 vs 0.62 ± 0.13, p = 0.01) and vastus lateralis (1.33 ± 0.21 vs 2.08 ± 0.29, p = 0.001) were significantly bigger in the Y group.


This is the first study to compare volume of spinopelvic muscles between ASD patients and a control group without spinal deformity. Our results demonstrate that muscular degeneration has a double origin: aging and deformity. Erector spinae, iliopsoas, and obliquus are the muscles most affected by degeneration.

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Author information




EF: Conception, data acquisition, formal analysis, and writing (draft-editing). WS: Conception, software, and revision. MK: Data acquisition, methodology, and revision. RC, AF, AF: Data acquisition and revision. PG: Conception, supervision, and revision. VL: Conception, software, and revision. All the authors approved the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Emmanuelle Ferrero.

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Conflict of interest

EF, MK, RC, AF, AF, and PG none. WS with Euros. VL with Globus, Nuvasive, Implanet, and Depuy Synthes.

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Approved by local ethic committee.

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Ferrero, E., Skalli, W., Khalifé, M. et al. Volume of spinopelvic muscles: comparison between adult spinal deformity patients and asymptomatic subjects. Spine Deform (2021). https://doi.org/10.1007/s43390-021-00357-9

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  • Adult spinal deformity
  • Muscle degeneration
  • 3D analysis
  • Scoliosis
  • Fat infiltration