ORIGINAL RESEARCH article
Front. Med.
Sec. Rheumatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1609660
Correlation and risk factor analysis of multifidus muscle atrophy in degenerative lumbar spondylolisthesis
Provisionally accepted
- 1Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China
- 2Yizheng Hospital of Traditional Chinese Medicine, Yangzhou, China
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Objective: We evaluated differences in multifidus muscle atrophy (MMA) among patients with degenerative lumbar spondylolisthesis (DLS) across various segments and grades of spondylolisthesis, analysed the correlation between DLS and MMA, identified risk factors contributing to MMA, and provided a clinical reference for the prevention and treatment of MMA.Methods: This retrospective study analysed data from 213 patients diagnosed with single-segment DLS between September 2020 and January 2022. Participants were categorised into three groups based on the affected spinal segment: L3 (n = 27), L4 (n = 140), and L5 (n = 46). The LCSA/GCSA ratio was calculated to assess the extent of MMA. Differences in MMA and its correlation with DLS severity were analysed across different spondylolisthesis grades. Furthermore, based on the Kjaer classification, patients were stratified into Mild and Severe MMA groups. A multivariate logistic regression analysis was performed to identify risk factors influencing the degree of MMA in DLS patients. Methods:The LCSA/GCSA ratio at the spondylolisthesis segment was significantly lower than that at the non-spondylolisthesis segment (P<0.001). When comparing LCSA/GCSA ratios between different grades of lumbar spondylolisthesis (Grade I and II), no statistically significant differences were observed (P>0.05). In the general population, a strong positive correlation was identified between the degree of MMA and the VAS and ODI scores for low back pain, whereas no significant correlation was found with the VAS score for leg pain. Age, BMI, and osteoporosis demonstrated statistically significant differences between the two groups (P<0.05). Multivariate logistic regression analysis identified age, BMI, and osteoporosis as significant risk factors for MMA progression in DLS patients (P<0.05).Conclusions: DLS patients exhibit MMA, with more pronounced atrophy at the spondylolisthesis-affected segment. Age, BMI, and osteoporosis are independent risk factors for MMA progression in DLS patients. Clinically, it is crucial to identify and monitor high-risk patients with these factors and implement early preventive and therapeutic interventions to mitigate disease progression
Keywords: Degenerative lumbar spondylolisthesis, Osteoporosis, Multifidus muscle atrophy, Paraspinal Muscles, Fat infiltration
Received: 10 Apr 2025; Accepted: 28 May 2025.
Copyright: © 2025 Zhang, Sun, Wu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaozhi Sun, Yizheng Hospital of Traditional Chinese Medicine, Yangzhou, China
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