Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study

Abstract Degenerative scoliosis (DS) is a significant health concern, affecting approximately 32–68% of the Chinese population aged 65 and above. This study aims to investigate the correlation between multifidus muscle atrophy and the severity of spinal curvature in DS patients, thereby providing ev...

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Main Authors: Jiangkai Yu, Cong Zhang, Yan Zhou, Jing Wang, Youheng Zhang, Yuntao Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-15622-4
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author Jiangkai Yu
Cong Zhang
Yan Zhou
Jing Wang
Youheng Zhang
Yuntao Wang
author_facet Jiangkai Yu
Cong Zhang
Yan Zhou
Jing Wang
Youheng Zhang
Yuntao Wang
author_sort Jiangkai Yu
collection DOAJ
description Abstract Degenerative scoliosis (DS) is a significant health concern, affecting approximately 32–68% of the Chinese population aged 65 and above. This study aims to investigate the correlation between multifidus muscle atrophy and the severity of spinal curvature in DS patients, thereby providing evidence-based recommendations for the clinical prevention and management of DS. After applying the inclusion and exclusion criteria, 231 patients with chronic low back pain admitted to the Department of Spinal Surgery, Zhongda Hospital affiliated with Southeast University between January 2023 and January 2024 were ultimately selected as the study population. Based on imaging diagnosis, chronic low back pain patients without DS were assigned to the control group (non-DS, n = 81), while patients with scoliosis were assigned to the observation group (DS, n = 150). The observation group was further subdivided into mild scoliosis (n = 72), moderate scoliosis (n = 56), and severe scoliosis (n = 22) groups based on the degree of curvature. ImageJ software was used to measure the cross-sectional area (CSA) of the multifidus muscle at the mid-level of L4 and L5 on T2-weighted magnetic resonance imaging (MRI) scans and calculate the degree of atrophy. The proportion of males and bone mineral density (BMD) were significantly higher in the non-DS group compared to the DS group (P < 0.05). The multifidus cross-sectional area (CSA) and functional cross-sectional area ratio (LCSA/GCSA) were significantly higher in the non-DS group than in the DS group (P < 0.05). Patients in the severe scoliosis group were significantly older than those in the mild and moderate groups, and had significantly lower BMD than the mild group (P < 0.05). The LCSA/GCSA was highest in the mild scoliosis group, lowest in the severe scoliosis group, and intermediate in the moderate group (P < 0.05). CSA was significantly higher in the mild scoliosis group than in the severe group (P < 0.05). In the mild and moderate scoliosis groups, the convex-side CSA and LCSA/GCSA were significantly greater than those on the concave side (P < 0.001). In the severe scoliosis group, no significant difference was found in convex-side versus concave-side CSA (P = 0.307), but convex-side LCSA/GCSA remained significantly greater than concave-side (P = 0.007). Pearson correlation and linear regression analysis showed no correlation between multifidus LCSA/GCSA and Cobb angle in non-DS patients (P > 0.05), but a significant negative correlation existed in DS patients (P < 0.05). The absolute value of the correlation coefficient increased with worsening scoliosis severity (severe group > moderate group > mild group). Multifidus muscle atrophy is closely associated with degenerative scoliosis. Multifidus LCSA/GCSA negatively correlates with scoliosis severity in DS patients, but not in non-DS patients. The convex side exhibits less atrophy compared to the concave side in DS patients. The difference in concave-convex sides is more pronounced in patients with mild to moderate conditions. Increasing age and reduced BMD may be associated with worsening scoliosis severity. When BMD <  − 0.900 T-Score, LCSA/GCSA < 0.805, and the patient is female, the likelihood of developing DS is high.
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spelling doaj-art-a3d6ad12d4334eb688edc38c0a4a35922025-08-20T03:47:10ZengNature PortfolioScientific Reports2045-23222025-08-0115111510.1038/s41598-025-15622-4Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional studyJiangkai Yu0Cong Zhang1Yan Zhou2Jing Wang3Youheng Zhang4Yuntao Wang5Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Orthopedics, Tianyinshan HospitalDepartment of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast UniversityAbstract Degenerative scoliosis (DS) is a significant health concern, affecting approximately 32–68% of the Chinese population aged 65 and above. This study aims to investigate the correlation between multifidus muscle atrophy and the severity of spinal curvature in DS patients, thereby providing evidence-based recommendations for the clinical prevention and management of DS. After applying the inclusion and exclusion criteria, 231 patients with chronic low back pain admitted to the Department of Spinal Surgery, Zhongda Hospital affiliated with Southeast University between January 2023 and January 2024 were ultimately selected as the study population. Based on imaging diagnosis, chronic low back pain patients without DS were assigned to the control group (non-DS, n = 81), while patients with scoliosis were assigned to the observation group (DS, n = 150). The observation group was further subdivided into mild scoliosis (n = 72), moderate scoliosis (n = 56), and severe scoliosis (n = 22) groups based on the degree of curvature. ImageJ software was used to measure the cross-sectional area (CSA) of the multifidus muscle at the mid-level of L4 and L5 on T2-weighted magnetic resonance imaging (MRI) scans and calculate the degree of atrophy. The proportion of males and bone mineral density (BMD) were significantly higher in the non-DS group compared to the DS group (P < 0.05). The multifidus cross-sectional area (CSA) and functional cross-sectional area ratio (LCSA/GCSA) were significantly higher in the non-DS group than in the DS group (P < 0.05). Patients in the severe scoliosis group were significantly older than those in the mild and moderate groups, and had significantly lower BMD than the mild group (P < 0.05). The LCSA/GCSA was highest in the mild scoliosis group, lowest in the severe scoliosis group, and intermediate in the moderate group (P < 0.05). CSA was significantly higher in the mild scoliosis group than in the severe group (P < 0.05). In the mild and moderate scoliosis groups, the convex-side CSA and LCSA/GCSA were significantly greater than those on the concave side (P < 0.001). In the severe scoliosis group, no significant difference was found in convex-side versus concave-side CSA (P = 0.307), but convex-side LCSA/GCSA remained significantly greater than concave-side (P = 0.007). Pearson correlation and linear regression analysis showed no correlation between multifidus LCSA/GCSA and Cobb angle in non-DS patients (P > 0.05), but a significant negative correlation existed in DS patients (P < 0.05). The absolute value of the correlation coefficient increased with worsening scoliosis severity (severe group > moderate group > mild group). Multifidus muscle atrophy is closely associated with degenerative scoliosis. Multifidus LCSA/GCSA negatively correlates with scoliosis severity in DS patients, but not in non-DS patients. The convex side exhibits less atrophy compared to the concave side in DS patients. The difference in concave-convex sides is more pronounced in patients with mild to moderate conditions. Increasing age and reduced BMD may be associated with worsening scoliosis severity. When BMD <  − 0.900 T-Score, LCSA/GCSA < 0.805, and the patient is female, the likelihood of developing DS is high.https://doi.org/10.1038/s41598-025-15622-4ScoliosisMultifidus muscleDegenerative diseaseMultifidus atrophy
spellingShingle Jiangkai Yu
Cong Zhang
Yan Zhou
Jing Wang
Youheng Zhang
Yuntao Wang
Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study
Scientific Reports
Scoliosis
Multifidus muscle
Degenerative disease
Multifidus atrophy
title Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study
title_full Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study
title_fullStr Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study
title_full_unstemmed Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study
title_short Correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective, cross-sectional study
title_sort correlation analysis between multifidus muscle atrophy and the severity of degenerative scoliosis retrospective cross sectional study
topic Scoliosis
Multifidus muscle
Degenerative disease
Multifidus atrophy
url https://doi.org/10.1038/s41598-025-15622-4
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