Shaoqing Chen’s research while affiliated with First Affiliated Hospital of China Medical University and other places

Background The degeneration and functional decline of paravertebral muscles (PVMs) are reported to be closely linked to the incidence of degenerative lumbar scoliosis (DLS), a spinal deformity of the mature skeleton. However, the functional role and degeneration of PVMs and their relationship to the development of spinal deformities remain controversial. Therefore, the present study analyzed the morphological changes in the PVMs of patients with DLS, and explored the relationship between PVM degeneration and spinal osseous parameters. Methods In this retrospective case-control study, we evaluated the PVM parameters of patients with DLS (n=120) and compared them with patients free of DLS (control group, n=120). The cross-sectional area (CSA) and computed tomography (CT) values of the PVM at the lumbar vertebra 1–5 levels were measured. Further, the lumbar scoliosis Cobb, lumbar lordotic, and apical vertebral rotation angles were measured on CT and radiographs in the DLS group, and the relationship between PVM changes and these factors was analyzed. Results In the control group, the PVM CSA and CT values differed insignificantly between the bilateral sides at all levels (P>0.05). In the DLS group, the CSAs of the multifidus (MF) and erector spinae (ES) were larger on the convex side than the concave side (P>0.05), whereas that of the psoas major (PM) was smaller on the convex side than the concave side (P<0.05). The CT value of the PVM was lower on the convex side at all levels (P<0.05). The CSA and CT values on both sides of the patients were lower in the DLS group than the control group at all levels (P<0.05). Further, the degree of PVM asymmetry at the apical vertebral level was positively correlated with the lumbar scoliosis (P<0.01) and apical vertebral rotation angles (P<0.05), but negatively correlated with the lumbar lordotic angle (P<0.05). Conclusions Asymmetric degeneration of the PVM was observed bilaterally in DLS patients, and the degeneration was more pronounced on the concave side than the convex side. This asymmetrical degeneration was closely associated with the severity of lumbar scoliosis, vertebral rotation, and loss of lumbar lordosis, and a stronger correlation was observed with the MF and ES than with the PM.

Background The relationship between sagittal spine alignment and vertebral bone marrow fat is unknown. We aimed to assess the relationship between vertebral bone marrow fat and sagittal spine alignment using chemical shift-encoding-based water–fat magnetic resonance imaging (MRI). Methods A total of 181 asymptomatic volunteers were recruited for whole spine X-ray and lumbar MRI. Spine typing was performed according to the Roussouly classification and measurement of vertebral fat fraction based on the chemical shift-encoding-based water–fat MRI. One-way analysis of variance (ANOVA) was used to analyze the differences in vertebral fat fraction between spine types. The post hoc least significant difference (LSD) test was utilized for subgroup comparison after ANOVA. Results Overall, the vertebral fat fraction increased from L1 to L5 and was the same for each spine type. The vertebral fat fraction was the highest in type 1 and lowest in type 4 at all levels. ANOVA revealed statistically significant differences in fat fraction among different spine types at L4 and L5 (P < .05). The post hoc LSD test showed that the fat fraction of L4 was significantly different (P < .05) between type 1 and type 4 as well as between type 2 and type 4. The fat fraction of L5 was significantly different between type 1 and type 3, between type 1 and type 4, and between type 2 and type 4 (P < .05). Conclusion Our study found that vertebral bone marrow fat is associated with sagittal spine alignment, which may serve as a new additional explanation for the association of sagittal alignment with spinal degeneration.

Background Bone-marrow water–fat composition is a useful imaging biomarker. However, the vertebral bone-marrow fat composition in healthy adults of east China is unknown. The aim of this study was to investigate differences in lumbar vertebral bone-marrow fat content between the sexes with age, using iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ). Methods Three-hundred-and-twenty-one healthy volunteers (age range 20–29 years: 32/33 men/women; 30–39 years: 40/37; 40–49 years: 21/45; 50–59 years: 26/37; ≥ 60 years: 15/26) were included in the present study. All subjects underwent IDEAL-IQ sequence imaging on a 3.0-T MR scanner. Bone-marrow fat-fraction ratio (FF%) was calculated for each vertebral body from sagittal lumbar images. Men and women were compared within age-groups by independent-samples t -tests, and different age-groups and vertebral segments were compared by Bonferroni post-hoc test. FF% correlations with age and body mass index (BMI) were analyzed with Spearman’s correlation coefficient. FF% and vertebral segment correlations were assessed by partial correlation analysis, after adjustment for sex and age. Results FF% averaged over L1–L5 was significantly higher in men than in women for the < 40-year age-groups ( P = 0.000). Bone-marrow fatty conversion was accelerated in women compared to men aged 40–49 years, but was similar in women and men aged > 60 years ( P > 0.05). FF% correlation with age was weakly positive in men ( r = 0.253, P = 0.003), and moderately positive in women ( r = 0.581, P < 0.001), but was non-significantly correlated with BMI and vertebral segments ( r = 0.218; r = 0.187, respectively). FF% was higher in the lower than in the upper lumbar segments ( P < 0.05). Conclusion IDEAL-IQ can accurately quantify lumbar bone-marrow fat infiltration. This increases with age, and differs between men and women and between lower and upper lumbar segments.