Spino-femoral muscles affect sagittal alignment and compensatory recruitment: a new look into soft tissues in adult spinal deformity
Type
Articles dans des revues avec comité de lectureAuteur
Date
2020Journal
European Spine JournalRésumé
Objective To quantify muscle characteristics (volumes and fat infiltration) and identify their relationship to sagittal malalignment
and compensatory mechanism recruitment.
Methods Female adult spinal deformity patients underwent T1-weighted MRI with a 2-point Dixon protocol from the
proximal tibia up to the T12 vertebra. 3D reconstructions of 17 muscles, including extensors and flexors of spine, hip and
knee, were obtained. Muscle volume standardized by bone volume and percentage of fat infiltration (Pfat) were calculated.
Correlations and regressions were performed.
Results A total of 22 patients were included. Significant correlations were observed between sagittal alignment and muscle
parameters. Fat infiltration of the hip and knee flexors and extensors correlated with larger C7-S1 SVA. Smaller spinal
flexor/extensor volumes correlated with greater PI-LL mismatch (r = − 0.45 and − 0.51). Linear regression identified volume
of biceps femoris as only predictor for PT (R2 = 0.34, p = 0.005) and Pfat of gluteus minimus as only predictor for SVA
(R2 = 0.45, p = 0.001). Sagittally malaligned patients with larger PT (26.8° vs. 17.2°) had significantly smaller volume and
larger Pfat of gluteus medius, gluteus minimus and biceps femoris, but similar values for gluteus maximus, the hip extensor.
Conclusion This study is the first to quantify the relationship between degeneration of spino-femoral muscles and sagittal
malalignment. This pathoanatomical study identifies the close relationship between gluteal, hamstring muscles and PT, SVA,
which deepens our understanding of the underlying etiology that contributes to adult spinal deformity.
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- 2021-06-20
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