Spinal–pelvic sagittal imbalance and paraspinal muscle degeneration in patients with degenerative lumbar spinal stenosis

Abstract Background: To explore the relationship between paraspinal muscle degeneration and changes in spine-pelvic sagittal parameters in patients with degenerative lumbar spinal stenosis (DLSS). Method: Twenty-eight patients with DLSS and complete imaging data from January 2020 to January 2022 were included. The relative cross-sectional area (RCSA) and fatty infiltration ratio (FIR) of the multifidus (MF) and erector spinae (ES) were obtained on lumbar magnetic resonance imaging. The sagittal vertical axis, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence, sacral slope and pelvic tilt were analysed by Spearman rank correlation analysis, and the relationship between paraspinal muscle parameters and spine–pelvic sagittal imbalance in patients with DLSS was determined. Correlation analysis of state parameters. Result: In the DLSS (L4-5) group, the right ES FIR was negatively correlated with the TK angle (r = −0.536, P < 0.05) and the left side had no significance. The left MF RCSA was associated with the TK angle. In the DLSS (L5-S1) group, the right MF RCSA and right ES RCSA were significantly positively correlated with the TK angle (r = 0. 502, P < 0.05, r = 0. 685, r = 0. 615, P < 0.05), and the left side has no meaning. Conclusion: A correlation was found between paraspinal muscle parameters and spine–pelvic sagittal parameters in patients with DLSS.