Journal of Spine Practice

Published date: Jul 31 2025

Journal Title: Journal of Spine Practice

Issue title: Journal of Spine Practice (JSP): Volume 4, Issue 3

Pages: 104 - 115

DOI: 10.18502/jsp.v4i3.18157

Archit Goyalgoyal.archit18@gmail.comDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, Sector C, New Delhi – 110070

Kalidutta Daskaliduttadas@gmail.comDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, Sector C, New Delhi – 110070

Tarush Rustagitarush.rustagi@gmail.comDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, Sector C, New Delhi – 110070

Study Design
Prospective observational study.

Objective
This study aimed to correlate the degree of paraspinal muscle fatty infiltration with the severity of lumbar canal stenosis, the demographic characteristics of the patient, the radiological parameters, and clinical scores.

Material and Methodology
This is a single-centre observational study in patients with secondary degenerative lumbar canal stenosis in patients older than 35 with radiological features matching the clinical symptoms. The demographic characteristics, fatty muscle infiltration (FMI) grade of multifidus and erector spinae muscles, lumbar canal stenosis (LCS) grade, neurological status, visual analogue scale (VAS) score, oswestry disability index (ODI) score, and endplate modic changes were recorded. The statistical analysis was done using SPSS v.25. For the comparison of categorical variables between groups, a chi-square test was used. A p-value <0.05 was considered to be statistically significant.

Results
The mean age of the study participants was 62.2 ±10.9 years. Of the 150 patients, 60.7% were women. The mean BMI of the patients was 27.8 ± 2.8 kg/m2. 121(80.7%) patients presented with low back pain at their first visit. 36.7% of the patients presented with claudication symptoms at their first visit. It was observed that 3.3% of the patients presented with cauda equina syndrome (CES). The mean duration of symptoms was 20.9 ± 16.3 months. The mean VAS score at the presentation was 5.9 ± 1.3. The mean ODI score at the first visit was 27.7 ± 6.1. Fatty muscle infiltration of the multifidus but not the erector spinae is associated with higher pain and ODI scores. The grade of FMI does not significantly correlate with the grade of LCS. Age significantly affects degenerative paraspinal muscle changes independent of the pathology. Other factors like BMI, gender, presence or absence of modic changes do not significantly affect the severity of stenosis, degree of paraspinal muscle fatty infiltration, and the pain and disability scores of the patients.

Conclusion
The study revealed that the grade of FMI does not significantly correlate with the grade of degenerative lumbar canal stenosis. Age significantly affects degenerative paraspinal muscle changes independent of the pathology.

Keywords: multifidus, erector spinae, low back pain, MRI, lumbar canal stenosis

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