A retrospective study of the effect of spinopelvic parameters on fatty infiltration in paraspinal muscles in patients with lumbar spondylolisthesis.

OBJECTIVE: The effect on fat infiltration (FI) of paraspinal muscles in degenerative lumbar spinal diseases has been demonstrated except for spinopelvic parameters. The present study is to identify the effect of spinopelvic parameters on FI of paraspinal muscle (PSM) and psoas major muscle (PMM) in patients with degenerative lumbar spondylolisthesis.

METHODS: A single-center, retrospective cross-sectional study of 160 patients with degenerative lumbar spondylolisthesis (DLS) and lumbar stenosis (LSS) who had lateral full-spine X-ray and lumbar spine MRI was conducted. PSM and PMM FIs were defined as the ratio of fat to its muscle cross-sectional area. The FIs were compared among patients with different pelvic tilt (PT) and pelvic incidence (PI), respectively.

RESULTS: The PSM FI correlated significantly with pelvic parameters in DLS patients, but not in LSS patients. The PSM FI in pelvic retroversion (PT>25°) was 0.54±0.13, which was significantly higher in DLS patients than in normal pelvis (0.41±0.14) and pelvic anteversion (PT<5°) (0.34±0.12). The PSM FI of DLS patients with large PI (>60°) was 0.50±0.13, which was higher than those with small (<45°) and normal PI (0.37±0.11 and 0.36±0.13). However, the PSM FI of LSS patients didn't change significantly with PT or PI. Moreover, the PMM FI was about 0.10-0.15, which was significantly lower than the PSM FI, and changed with PT and PI in a similar way of PSM FI with much less in magnitude.

CONCLUSION: FI of the paraspinal muscles increased with greater pelvic retroversion or larger pelvic incidence in DLS patients, but not in LSS patients.