2023, Vol. 27 ›› Issue (36): 5891-5897

Relationship between the degeneration of paraspinal muscle and sagittal alignment

Liu Ziwen1, 2, Yang Yuming1, 2, Xie Hongru3, Zhang Zepei1, Xu Haoxiang1, Miao Jun1   

Abstract: BACKGROUND: The parameters of the spine and pelvis are interrelated. The changes in their values are closely related to the occurrence, development and symptoms of degenerative spinal diseases. At the present stage, clinical workers focus on the changes in postoperative coronal and sagittal parameters to evaluate the overall balance of the spine after operation, while ignoring the relationship with paraspinal muscle and the role of paraspinal muscle in the process of spinal degeneration.
OBJECTIVE: To summarize the previous studies on the relationship between the degeneration of paraspinal muscle and sagittal alignment, and analyze the interaction between changes in the relative position of skeleton structures and degeneration of paraspinal muscle during spinal degeneration.
METHODS: A computer-based online retrieval of CNKI, WanFang, and VIP was conducted with the Chinese key words “sagittal spinal deformity, sagittal alignment, spinal-pelvic parameter, paraspinal muscle, degeneration, human cadaver model, imaging, MRI”. The retrieval of Medline, PubMed, and Web of Science databases was performed with the English key words “sagittal spinal deformity, sagittal alignment, spinal-pelvic parameter, paraspinal muscle, degeneration, imaging, MRI”. The preliminary screening was carried out by reading the title and abstract, and the literature was screened according to the inclusion and exclusion criteria. Finally, a total of 78 articles were included for result analysis.
RESULTS AND CONCLUSION: (1) In recent years, researchers have noticed that paraspinal muscles play a corresponding role in maintaining sagittal alignment, and spinal degeneration can be delayed by protecting and improving paraspinal muscle function. (2) The researchers used different methods to detect the degree of paraspinal muscle degeneration, and selected different kinds of sagittal parameters to describe the sagittal alignment. After analyzing the degeneration of paraspinal muscles and the changes in sagittal parameters, we found that there was a correlation between them, and the correlation was affected by age, race and other factors. (3) Poor sagittal alignment is an important anatomic factor determining paraspinal muscle degeneration. A high pelvic incidence of anatomical parameters has often been reported as a risk factor for sagittal alignment. However, the smaller pelvic incidence is more prone to sagittal imbalance due to the smaller compensatory capacity of paraspinal muscles. (4) The paraspinal muscles continue to affect the sagittal alignment through a compensatory mechanism continuously. To combat spinal imbalance during spinal degeneration, the paraspinal muscles are in a state of high muscle load, causing pain, fatigue, atrophy and degeneration.

Key words: sagittal spinal deformity, sagittal alignment, spinal-pelvic parameter, paraspinal muscle, degenerative disease, human cadaver model, imaging, magnetic resonance imaging