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. 2023 Jul 27;24(1):613.
doi: 10.1186/s12891-023-06595-4.

Fatty infiltration of the cervical multifidus musculature and its clinical correlation to cervical spondylosis

Zhifei Li  1 , Qinqiu Liang  2 , He Li  3 , Xiaocheng Lin  4 , Jiwen Meng  2 , Daishui Yang  5 , Chengwei Li  2 , Yuanyao Liang  2 , Yin Yang  2 , Yuanfang Lin  6 , Ziyang Liang  7   8
Affiliations

Fatty infiltration of the cervical multifidus musculature and its clinical correlation to cervical spondylosis

Zhifei Li et al. BMC Musculoskelet Disord. .

Abstract

Purpose: Fat infiltration (FI) of the deep neck extensor muscles has been shown to be associated with poor outcomes in cervical injury, mechanical neck pain, and axial symptoms after cervical spine surgery. However, information is scarce on the severity of FI in cervical extensors associated with different clinical syndromes in patients with cervical spondylosis.

Objective: To investigate the relationship between the severity of FI in the cervical multifidus musculature and its clinical correlates in the syndromes and sagittal alignment of patients with cervical spondylosis.

Methods: This study was conducted as a retrospective study of twenty-eight healthy volunteers (HV) together with sixty-six patients who underwent cervical radiculopathy (CR), degenerative myelopathy (DM), and axial joint pain (AJP) from January 2020 to March 2022. MRI was used to measure the fat cross-sectional area (FCSA), functional muscle cross-sectional area (FMCSA), total muscle cross-sectional area (TMCSA), FI ratio of the cervical multifidus musculature at each cervical level from the C3 to C6 segments and the cervical lordosis angle in the included subjects.

Results: The difference in the FCSA and FI ratio in patient groups with cervical spondylosis was significantly greater than that of the HV group (P < 0.05), and the Cobb angle of the DM group, AJP group and HV group was significantly greater than that of the CR group (P < 0.05). The FI ratio comparison showed no significant difference by sex, and the comparison of FCSA, FMCSA, TMCSA and FI ratio showed no significant difference by age range from 35 to 69 in the included subjects. The FCSA and TMCSA in patients with cervical spondylosis were positively related to the Cobb angle (rs= 0.336, P = 0.006, rs =0.319, P = 0.009, respectively), and the FI ratio was inversely correlated with the Cobb angle (rs= -0.285, P = 0.020) and positively correlated with age (rs =0.261, P = 0.034). In the HV group, FMCSA was inversely correlated with age (rs= -0.400, P = 0.035), while the FI ratio had a positive correlation with age (rs= -0.423, P = 0.025).

Conclusion: Compared with healthy subjects, a more severe degree of FI in the multifidus musculature and sagittal imbalance were found in patients with cervical spondylosis. These two imaging features are considered to be important concomitant phenomena of cervical spondylosis, and the more severe FI is, the worse the sagittal imbalance. However, each syndrome had no obvious difference in FI in the multifidus musculature.

Keywords: Cervical multifidus; Correlation analysis; Cross-sectional area; Fat infiltration; Radiological measurement.

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Conflict of interest statement

All the authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
TMCSA and FI ratio of the multifidus muscle were measured. (Left) This area within the yellow line represents the multifidus TMCSA. (Right) The red area within the yellow line represents the fatty amount of the multifidus
Fig. 2
Fig. 2
Depiction of the measurement of the C2-C7 Cobb angle. The C2-C7 Cobb angle is defined as the angle between two lines perpendicular to the lower endplates of C2 and C7
See this image and copyright information in PMC

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