The Relationship between the Morphology of Psoas Major and Clinical Symptoms in Patients with Symptomatic Multi-segmental Degenerative Lumbar Spinal Stenosis
Objective To investigate the correlation between MRI and CT morphological parameters of psoas major and clinical symptoms in patients with symptomatic multi-segmental degenerative lumbar spinal stenosis(SMDLSS).Methods A retrospective analysis was conducted on the clinical data of 122 patients with SMDLSS who were admitted to our hospital from January 2021 to December 2023.All patients were divided into groups with mild-moderate dysfunction(≤42％)and severe dysfunction(＞42％)based on their Oswestry disability index(ODI)scores.Patients were also divided into groups with no or mild pain(≤3 on the visual analog scale,VAS)and moderate-severe pain(＞3 on the VAS).Axial CT images corresponding to the L3/4 intervertebral disc level were selected to measure the psoas major index,average CT value of the psoas major,and psoas major morphological change score(the average ratio of the short axis to the long axis of both psoas major muscles).Multivariate Logistic regression analysis was used to identify risk factors that may affect severe dysfunction and moderate-severe pain.Results Male patients had higher psoas major indices than female patients(P＜0.001).Patients in the severe dysfunction group had lower psoas major indices(P＜0.001)and average CT values of the psoas major(P＜0.001)compared with patients in the mild-moderate dysfunction group.Patients with no or mild pain(VAS ≤ 3)had higher psoas major indices and average CT values of the psoas major than patients with moderate-severe back pain(P＜0.001).Multivariate Logistic regression analysis showed that an increase in the average CT value of the psoas major(OR=0.802,P=0.016)was a protective factor for severe dysfunction in patients with SMDLSS,and an increase in the psoas major index(OR=0.763,P=0.012)was a protective factor for moderate-severe back pain in these patients.Conclusion In patients with SMDLSS,an increase in the average CT value of the psoas major and psoas major index are protective factors for the development of dysfunction and moderate-severe back pain,respectively.
万方数据
维普
