| Objective To study the morphological manifestations of multifidus imaging in patients with degenerative lumbar spondylolisthesis(DLS) and to investigate the factors affecting fatty infiltration of multifidus muscle and the relationship between fatty infiltration and DLS.Methods Forty-six patients diagnosed with L4/5 or L5/S1 Ⅰ° DLS at the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2019 to October 2021 were selected to be included in the DLS group; 48 healthy physical examiners who underwent lumbar MRI examination at our physical examination clinic during the same period were included in the control group. Age, sex, body mass index (BMI), plasma cholesterol, bilateral multifidus muscle cross- sectional area and fat ratio at the L4/5 and L5/S1 intervertebral space levels, lumbar lordosis angle (LLA), and sacral slope (SS) were counted in both groups. The visual analogue score (VAS), Oswestry dysfunction index (ODI), and duration of symptoms were measured in patients with DLS.Results The LLA and SS in the DLS group were greater than those in the control group, and the difference was statistically significant (P<0.05). The percentage of fat in the multifidus muscle was greater in the DLS group than in the control group, and the difference was statistically significant (P<0.05); the difference in the cross-sectional area of the multifidus muscle between the two groups was not statistically significant (P>0.05); the percentage of fat in the multifidus muscle was greater in the spondylolisthesis segment than in the non-spondylolisthesis segment, and the difference was statistically significant (P<0.05). The percentage of fat in the L4/5 intervertebral space multifidus muscle was significantly correlated with age in those with degenerative L4 DLS (r=0.642). Multifidus fat percentage was a risk factor for DLS (OR=1.216, OR=1.090).Conclusion In patients with DLS, lumbar multifidus degeneration imaging shows increased fatty infiltration and decreased muscle tissue area, and the fatty infiltration of multifidus muscle at the spondylolisthesis segment is greater than that at the non-spondylolisthesis segment. Fatty infiltration of the multifidus muscle is significantly correlated with age in those with L4 spondylolisthesis, and fatty infiltration of the multifidus muscle is a risk factor for DLS. |
