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Fat infiltration of the posterior paraspinal muscles is inversely associated with the fat infiltration of the psoas muscle: a potential compensatory mechanism in the lumbar spine – Lumbar Fusion

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The article discusses the function of the paraspinal muscles, specifically the psoas muscle, in maintaining an upright posture. The study aims to determine how the psoas muscle and the posterior paraspinal muscles (PPM) interact with each other. A retrospective review of patients undergoing posterior lumbar fusion surgery was conducted, and MRI-based quantitative assessments were performed. The results showed that as the fat infiltration (FI) in the PPM increased, the FI in the psoas muscle decreased, suggesting a compensatory mechanism. This decrease in muscular strength may be indicative of the psoas muscle stabilizing the lumbar spine segmentally. Overall, the study provides insights into the complex anatomy and function of the paraspinal muscles in maintaining posture

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced treatment facility on Harley Street UK

Published article

: As the FI(PPM) increases, the FI(Psoas) decreases. Increased FI is a surrogate marker for a decrease in muscular strength. Since the psoas and the PPM both segmentally stabilize the lumbar spine, these results may be indicative of a potential compensatory mechanism. Due to the weakened PPM, the psoas may compensate for a loss in strength in order to stabilize the spine segmentally.

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BMC Musculoskelet Disord. 2023 Oct 27;24(1):846. doi: 10.1186/s12891-023-06967-w.ABSTRACTBACKGROUND: The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a hip flexor, the psoas muscle and its complex anatomy suggest that the muscle has other functions involved in stabilizing the lumbar,

BMC Musculoskelet Disord. 2023 Oct 27;24(1):846. doi: 10.1186/s12891-023-06967-w.

ABSTRACT

BACKGROUND: The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a hip flexor, the psoas muscle and its complex anatomy suggest that the muscle has other functions involved in stabilizing the lumbar spine. The aim of this study is to determine how the psoas muscle and the posterior paraspinal muscles (PPM; erector spinae and multifidus) interact with each other.

METHODS: A retrospective review including patients undergoing posterior lumbar fusion surgery between 2014 and 2021 at a tertiary care center was conducted. Patients with a preoperative lumbar magnetic resonance imaging (MRI) scan performed within 12 months prior to surgery were considered eligible. Exclusion criteria included previous spinal surgery at any level, lumbar scoliosis with a Cobb Angle > 20° and patients with incompatible MRIs. MRI-based quantitative assessments of the cross-sectional area (CSA), the functional cross-sectional area (fCSA) and the fat area (FAT) at L4 was conducted. The degree of fat infiltration (FI) was further calculated. FI thresholds for FIPPM were defined according to literature and patients were divided into two groups (< or ≥ 50% FIPPM).

RESULTS: One hundred ninetypatients (57.9% female) with a median age of 64.7 years and median BMI of 28.3 kg/m2 met the inclusion criteria and were analyzed. Patients with a FIPPM ≥ 50% had a significantly lower FI in the psoas muscle in both sexes. Furthermore, a significant inverse correlation was evident between FIPPM and FIPsoas for both sexes. A significant positive correlation between FATPPM and fCSAPsoas was also found for both sexes. No significant differences were found for both sexes in both FIPPM groups.

: As the FIPPM increases, the FIPsoas decreases. Increased FI is a surrogate marker for a decrease in muscular strength. Since the psoas and the PPM both segmentally stabilize the lumbar spine, these results may be indicative of a potential compensatory mechanism. Due to the weakened PPM, the psoas may compensate for a loss in strength in order to stabilize the spine segmentally.

PMID:37891498 | DOI:10.1186/s12891-023-06967-w

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Fat infiltration of the posterior paraspinal muscles is inversely associated with the fat infiltration of the psoas muscle: a potential compensatory mechanism in the lumbar spine

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BMC Musculoskelet Disord. 2023 Oct 27;24(1):846. doi: 10.1186/s12891-023-06967-w.ABSTRACTBACKGROUND: The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a hip flexor, the psoas muscle and its complex anatomy suggest that the muscle has other functions involved in stabilizing the lumbar
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