Abstract
OBJECTIVE: To analyze the correlation between spine-pelvis parameters, age and lumbar paravertebral muscle degeneration in middle-aged and older adults. METHOD: This retrospective study involved 143 middle-aged and elderly patients with suspected lumbar paravertebral muscle degeneration treated at The Third Hospital of Hebei Medical University between January 2021 and June 2023. Based on confirmed diagnoses, patients were divided into a degenerative group (57 cases) and a non-degenerative group (86 cases). Clinical data were analyzed to explore the relationship between pelvic parameters, age, and lumbar paravertebral muscle degeneration. Univariate and multivariate logistic regression were used to identify risk factors, and Receiver Operating Characteristic (ROC) analysis was performed to evaluate the predictive value of these factors. Differences in areas under the curve (AUC) for clinical factors were assessed using the DeLong test. RESULT: No significant differences were found between the two groups in clinical data, except for age (P<0.05). Comparison of spine-pelvis parameters revealed that the pelvic tilt (PT) and pelvic incidence (PI) were significantly higher in the degenerative group than those in the non-degenerative group, while the sacral slope (SS) and lumbar lordosis (LL) were lower (all P<0.05). Additionally, the CSA ratios between the third and fourth lumbar vertebrae (L3/4) and between the fourth and fifth lumbar vertebrae (L4/5) were found to be significantly lower in the degenerative group as opposed to those in the non-degenerative group (all P<0.05). Kendall's analysis showed that age and spine-pelvis parameters (PT, PI) were positively correlated with lumbar paravertebral muscle degeneration (OR=0.733, 0.639, 0.695; P<0.0001). In contrast, spine-pelvic parameters (SS, LL) were negatively correlated with degeneration (OR=-0.695, -0.698; P<0.0001). Pearson's correlation analysis also revealed a positive correlation between age and spine-pelvic parameters (PT, PI) (r=0.826, 0.985, P<0.001), and a negative correlation between age and spine-pelvic parameters (SS, LL) (r=-0.861, -0.942, P<0.001). Additionally, spine-pelvic parameter PT was negatively correlated with CAS ratio of L3/4 disc levels (r=-0.412, P<0.000). Logistic multivariate regression analysis identified age (OR=0.616, P<0.0001), PT (OR=0.827, P<0.0001), SS (OR=1.095, P=0.004), LL (OR=1.148, P=0.019), PI (OR=0.853, P<0.0001), CAS ratio of L3/4 (OR=1.977, P=0.002) and CAS ratio of L4/5 (OR=1.739, P=0.009) levels as independent risk factors for lumbar paravertebral muscle degeneration (all P<0.05). ROC results showed that the AUCs for age, PT, SS, LL, PI, L3/4, and L4/5 in predicting lumbar paravertebral muscle degeneration in middle-aged and elderly people were 0.949, 0.828, 0.642, 0.779, 0.850, 0.683, 0.677, respectively (all P<0.05). CONCLUSION: Lumbar paravertebral muscle degeneration in middle-aged and elderly individuals is significantly associated with both age and spine-pelvic parameters. These findings suggest that degeneration is not only age-related but also influenced by spine-pelvic configuration, providing a clinical basis for preventing lumbar paravertebral muscle degeneration.