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Volume of spinopelvic muscles: comparison between adult spinal deformity patients and asymptomatic subjects

Article dans une revue avec comité de lecture
Author
FERRERO, Emmanuelle
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
SKALLI, Wafa
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
KHALIFÉ, Marc
300119 Hôpital Européen Georges Pompidou [APHP] [HEGP]
CARLIER, Robert
81674 Service de Radiologie et imagerie médicale
FEYDY, Antoine
51589 Service de Radiologie [CHU Cochin]
FELTER, Adrien
81674 Service de Radiologie et imagerie médicale
GUIGUI, Pierre
300119 Hôpital Européen Georges Pompidou [APHP] [HEGP]
LAFAGE, Virginie
358726 Hospital for Special Surgery

URI
http://hdl.handle.net/10985/20471
DOI
10.1007/s43390-021-00357-9
Date
2021
Journal
Spine Deformity

Abstract

Purpose: Spinal muscles are a major component of posture in spinal pathologies and changes to the spine with aging. Specifically, spinopelvic muscles may compensate for underlying anomalies such as pelvic retroversion, knee flexion, and cervical or thoracic spinal balance abnormalities. To increase understanding between muscular characteristics and compensatory mechanisms, this study aimed to compare the volume of spinopelvic muscles in adults with a spinal deformity (ASD) to a control group of well-aligned adult subjects. Methods: Twenty-eight lumbar ASD patients [Cobb angle > 20°, > 40 years old (yo)] were prospectively included and compared to 35 normal subjects divided into 2 different groups: one group of young (Y) subjects (n = 23, < 20 yo) and one group of old (O) subjects (n = 12, > 40 yo). All subjects had a fat/water separation MRI (from C7 to the knees). Volumetric 3D reconstructions of 30 spinopelvic muscles were performed and muscles volumes were compared. Results: Mean age was 60 ± 16 yo, without significant differences between the ASD and O groups (57 ± 11 yo). Age and BMI were smaller in the young group. Mean Cobb angle of the ASD group was 45 ± 11°. Comparing the ASD and O groups, total muscular volume was similar; however, erector spinae (0.24 ± 0.06 vs 0.68 ± 0.08 dm3, p = 0.001), iliopsoas (0.49 ± 0.09 vs 0.60 ± 0.09 dm3, p = 0.001) and obliquus (0.42 ± 0.08 vs 0.50 ± 0.08 dm3, p = 0.02) were significantly smaller in the ASD group. Comparing the Y and the ASD groups, total muscular volume was higher in the Y group than the ASD group (+ 3.3 dm3, p = 0.003) and erector spinae (0.24 ± 0.06 vs 0.74 ± 0.08, p = 0.0001), gluteus medius (0.51 ± 0.07 vs 0.62 ± 0.13, p = 0.01) and vastus lateralis (1.33 ± 0.21 vs 2.08 ± 0.29, p = 0.001) were significantly bigger in the Y group. Conclusion: This is the first study to compare volume of spinopelvic muscles between ASD patients and a control group without spinal deformity. Our results demonstrate that muscular degeneration has a double origin: aging and deformity. Erector spinae, iliopsoas, and obliquus are the muscles most affected by degeneration.

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