Rate of paravertebral muscle fat infiltration versus spinal degeneration in asymptomatic populations: an age-aggregated cross-sectional simulation study.

Rebecca Crawford, Thomas Volken, Stephanie Valentin, Markus Melloh, James Elliott

Research output: Contribution to journalArticle

Abstract

Background

The spinal column including its vertebrae and disks has been well examined and extensively reported in relation to age-aggregated degeneration. In contrast, paravertebral muscles are poorly represented in describing normative degeneration. Increasing evidence points to the importance of paravertebral muscle quality in low back health, and their potential as a modifiable factor in low back pain (LBP). Studies examining normative decline of paravertebral muscles are needed to advance the field’s etiological understanding. With a novel approach and based on published data, we establish and compare decline rates of imaging features for degeneration of lumbar vertebrae and disks, versus fatty infiltration in paravertebral muscles in asymptomatic adults.

 

Methods

Our cross-sectional simulation study examined age-aggregated data from three published studies who reported on asymptomatic adults spanning 18–60 years. Prevalence rates of imaging degenerative features of the spinal column were examined via logistic regression and compared with percentage fatty infiltration in erector spinae, multifidus and psoas using synthetic data and Monte Carlo simulation with 10,000 endpoint-specific regression iterations. General linear regression models were employed to estimate marginal effects of age reported as a one-year change rate (with 95 % confidence intervals) for comparisons between all reported spinal features.

 

Results

Declines in multifidus (0.24 & 0.11 %/year), erector spinae (0.13 & 0.07 %/year), and psoas (0.04 %/year) occur at similarly slow rates to disk protrusion (0.25 %/year), annular fissure (0.15 %/year), and spondylolisthesis (0.29 %/year). Multifidus showed a trend for faster decline than erector spinae, particularly in men. Of the features examined, disk signal loss declined fastest, and psoas muscle the slowest.

 

Conclusions

Degeneration of lumbar paravertebral muscles occurs slowly in asymptomatic adults, with a tendency to be most pronounced in multifidus. Rate of decline of spinal structures represents a novel variable that warrants inclusion as a known feature of the expected degenerative cascade, and to provide a basis for comparison to diseases of the spine in research and clinical practice. Concurrent examination of spinal features using advanced imaging to improve muscle analysis would be a strong addition to the field.

Original languageEnglish
Article number21
JournalScoliosis and Spinal Disorders
Volume11
Issue number21
DOIs
Publication statusPublished - 5 Aug 2016
Externally publishedYes

Fingerprint

Paraspinal Muscles
Cross-Sectional Studies
Fats
Muscles
Population
Spine
Linear Models
Psoas Muscles
Lumbar Vertebrae
Low Back Pain
Logistic Models
Confidence Intervals
Health
Research

Cite this

@article{43bb98b4e82649708e599ab4c41b1716,
title = "Rate of paravertebral muscle fat infiltration versus spinal degeneration in asymptomatic populations: an age-aggregated cross-sectional simulation study.",
abstract = "Background The spinal column including its vertebrae and disks has been well examined and extensively reported in relation to age-aggregated degeneration. In contrast, paravertebral muscles are poorly represented in describing normative degeneration. Increasing evidence points to the importance of paravertebral muscle quality in low back health, and their potential as a modifiable factor in low back pain (LBP). Studies examining normative decline of paravertebral muscles are needed to advance the field’s etiological understanding. With a novel approach and based on published data, we establish and compare decline rates of imaging features for degeneration of lumbar vertebrae and disks, versus fatty infiltration in paravertebral muscles in asymptomatic adults.   Methods Our cross-sectional simulation study examined age-aggregated data from three published studies who reported on asymptomatic adults spanning 18–60 years. Prevalence rates of imaging degenerative features of the spinal column were examined via logistic regression and compared with percentage fatty infiltration in erector spinae, multifidus and psoas using synthetic data and Monte Carlo simulation with 10,000 endpoint-specific regression iterations. General linear regression models were employed to estimate marginal effects of age reported as a one-year change rate (with 95 {\%} confidence intervals) for comparisons between all reported spinal features.   Results Declines in multifidus (0.24 & 0.11 {\%}/year), erector spinae (0.13 & 0.07 {\%}/year), and psoas (0.04 {\%}/year) occur at similarly slow rates to disk protrusion (0.25 {\%}/year), annular fissure (0.15 {\%}/year), and spondylolisthesis (0.29 {\%}/year). Multifidus showed a trend for faster decline than erector spinae, particularly in men. Of the features examined, disk signal loss declined fastest, and psoas muscle the slowest.   Conclusions Degeneration of lumbar paravertebral muscles occurs slowly in asymptomatic adults, with a tendency to be most pronounced in multifidus. Rate of decline of spinal structures represents a novel variable that warrants inclusion as a known feature of the expected degenerative cascade, and to provide a basis for comparison to diseases of the spine in research and clinical practice. Concurrent examination of spinal features using advanced imaging to improve muscle analysis would be a strong addition to the field.",
author = "Rebecca Crawford and Thomas Volken and Stephanie Valentin and Markus Melloh and James Elliott",
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language = "English",
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journal = "Scoliosis and Spinal Disorders",
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number = "21",

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Rate of paravertebral muscle fat infiltration versus spinal degeneration in asymptomatic populations : an age-aggregated cross-sectional simulation study. / Crawford, Rebecca; Volken, Thomas; Valentin, Stephanie; Melloh, Markus; Elliott, James.

In: Scoliosis and Spinal Disorders, Vol. 11, No. 21, 21, 05.08.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Rate of paravertebral muscle fat infiltration versus spinal degeneration in asymptomatic populations

T2 - an age-aggregated cross-sectional simulation study.

AU - Crawford, Rebecca

AU - Volken, Thomas

AU - Valentin, Stephanie

AU - Melloh, Markus

AU - Elliott, James

PY - 2016/8/5

Y1 - 2016/8/5

N2 - Background The spinal column including its vertebrae and disks has been well examined and extensively reported in relation to age-aggregated degeneration. In contrast, paravertebral muscles are poorly represented in describing normative degeneration. Increasing evidence points to the importance of paravertebral muscle quality in low back health, and their potential as a modifiable factor in low back pain (LBP). Studies examining normative decline of paravertebral muscles are needed to advance the field’s etiological understanding. With a novel approach and based on published data, we establish and compare decline rates of imaging features for degeneration of lumbar vertebrae and disks, versus fatty infiltration in paravertebral muscles in asymptomatic adults.   Methods Our cross-sectional simulation study examined age-aggregated data from three published studies who reported on asymptomatic adults spanning 18–60 years. Prevalence rates of imaging degenerative features of the spinal column were examined via logistic regression and compared with percentage fatty infiltration in erector spinae, multifidus and psoas using synthetic data and Monte Carlo simulation with 10,000 endpoint-specific regression iterations. General linear regression models were employed to estimate marginal effects of age reported as a one-year change rate (with 95 % confidence intervals) for comparisons between all reported spinal features.   Results Declines in multifidus (0.24 & 0.11 %/year), erector spinae (0.13 & 0.07 %/year), and psoas (0.04 %/year) occur at similarly slow rates to disk protrusion (0.25 %/year), annular fissure (0.15 %/year), and spondylolisthesis (0.29 %/year). Multifidus showed a trend for faster decline than erector spinae, particularly in men. Of the features examined, disk signal loss declined fastest, and psoas muscle the slowest.   Conclusions Degeneration of lumbar paravertebral muscles occurs slowly in asymptomatic adults, with a tendency to be most pronounced in multifidus. Rate of decline of spinal structures represents a novel variable that warrants inclusion as a known feature of the expected degenerative cascade, and to provide a basis for comparison to diseases of the spine in research and clinical practice. Concurrent examination of spinal features using advanced imaging to improve muscle analysis would be a strong addition to the field.

AB - Background The spinal column including its vertebrae and disks has been well examined and extensively reported in relation to age-aggregated degeneration. In contrast, paravertebral muscles are poorly represented in describing normative degeneration. Increasing evidence points to the importance of paravertebral muscle quality in low back health, and their potential as a modifiable factor in low back pain (LBP). Studies examining normative decline of paravertebral muscles are needed to advance the field’s etiological understanding. With a novel approach and based on published data, we establish and compare decline rates of imaging features for degeneration of lumbar vertebrae and disks, versus fatty infiltration in paravertebral muscles in asymptomatic adults.   Methods Our cross-sectional simulation study examined age-aggregated data from three published studies who reported on asymptomatic adults spanning 18–60 years. Prevalence rates of imaging degenerative features of the spinal column were examined via logistic regression and compared with percentage fatty infiltration in erector spinae, multifidus and psoas using synthetic data and Monte Carlo simulation with 10,000 endpoint-specific regression iterations. General linear regression models were employed to estimate marginal effects of age reported as a one-year change rate (with 95 % confidence intervals) for comparisons between all reported spinal features.   Results Declines in multifidus (0.24 & 0.11 %/year), erector spinae (0.13 & 0.07 %/year), and psoas (0.04 %/year) occur at similarly slow rates to disk protrusion (0.25 %/year), annular fissure (0.15 %/year), and spondylolisthesis (0.29 %/year). Multifidus showed a trend for faster decline than erector spinae, particularly in men. Of the features examined, disk signal loss declined fastest, and psoas muscle the slowest.   Conclusions Degeneration of lumbar paravertebral muscles occurs slowly in asymptomatic adults, with a tendency to be most pronounced in multifidus. Rate of decline of spinal structures represents a novel variable that warrants inclusion as a known feature of the expected degenerative cascade, and to provide a basis for comparison to diseases of the spine in research and clinical practice. Concurrent examination of spinal features using advanced imaging to improve muscle analysis would be a strong addition to the field.

U2 - 10.1186/s13013-016-0080-0

DO - 10.1186/s13013-016-0080-0

M3 - Article

VL - 11

JO - Scoliosis and Spinal Disorders

JF - Scoliosis and Spinal Disorders

SN - 2397-1789

IS - 21

M1 - 21

ER -