Longitudinal Analysis of Paraspinal Muscle Cross-Sectional Area During Early Adulthood - A 10-Year Follow-Up MRI Study

Abstract

Only a few previous studies have investigated paraspinal musculature (i.e., multifidus (MF), psoas major (PSM), erector spinae (ES)) in longitudinal, population-based settings. This study aimed to evaluate changes in the cross-sectional area (CSA) of the paraspinal muscles between the ages of 20 and 30 years. The study population consisted of a sub-cohort from the Northern Finland Birth Cohort 1986 (n = 298; 156 men, 142 women). Baseline magnetic resonance imaging was performed at a mean age of 21.3 years and follow-up imaging at 30.6 years. The CSA measurements were performed by tracing the paraspinal muscle outlines individually (MF, ES, PM) and all combined (total muscle area (TMA)) at the L4 cranial endplate level. The longitudinal data analysis was performed using generalized estimating equations modelling. The CSA of MF and ES increased during the follow-up among both sexes (men: MF + 5.7%, p < 0.001; ES + 2.7%, p = 0.001; and women: MF + 10.5%, p < 0.001; ES 9.2%, p = 0.001). The CSA of PM decreased among men (PM -4.0%, p < 0.001) but not among women (PM + 0.5%, p = 0.553). TMA increased significantly only among women (men: +0.5%, p = 0.425; women: +6.5%, p < 0.001). The increases in ES and TMA were more distinct among women than men (p < 0.001). Our study demonstrated clear age- and sex-related changes in paraspinal muscle size in early adulthood.

Figure 1

Left: Sagittal plane presenting measurement level. L3 = 3^rd lumbar vertebra, L4 = 4^th lumbar vertebra, L5 = 5^th lumbar vertebra, S1 = 1^st sacral vertebra. Right: Axial plane on L4 upper endplate level. MF = multifidus, ES = Erector spinae, QL = quadratus lumborum, PM = Psoas major, IVD = intervertebral disc, IVC = Inferior vena cava, A = Abdominal aorta.

Figure 2

Measurement outlines in axial plane at L4-vertebra cranial endplate level.