• Kwong Hang Yeung, Gene Chi Wai Man, Lin Shi, Steve Cheuk Ngai Hui, Chileka Chiyanika, Tsz Ping Lam, Ng Bobby Kin Wah BKW Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kon, Cheng Jack Chun Yiu JCY Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong , and Chu Winnie Chiu Wing WCW Department of Imaging and Interventional Radiology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shati.
• Department of Imaging and Interventional Radiology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
• Spine. 2019 Oct 1; 44 (19): 1356-1363.

Study DesignA cross-sectional study.ObjectiveTo investigate and compare any morphological differences in paraspinal muscles (PSM) between adolescent idiopathic scoliosis (AIS) patients (with severe or non-severe curves) and healthy controls.Summary Of Background DataSeveral studies have reported abnormalities in biochemical, electromyographic activity, and histological changes of PSM in AIS. However, these studies only had qualitative data and without comparison with controls. Changes of muscle mass and mean density at the lumbar region have been described for scoliotic spines. All these findings suggested that imbalance of PSM in AIS could be a contributing factor to the development of severe scoliotic curve.MethodsT2-weighted MR images with multi-planar reconstruction were acquired in 41 Chinese AIS girls with a primary right-sided thoracic curve and 23 age-matched controls. In AIS, measurements of PSM were taken on both concavity and convexity of scoliosis starting from two vertebrae above and two below the apex. Morphological assessments of the multifidus (MF) and erector spinae (ES) muscles on both sides were made including signal intensity (SI) and fat deposition using manual tracing and thresholding technique, respectively. Same parameters were measured in controls at matched vertebrae. One-way analysis of variance (ANOVA) and Pearson correlation tests were used for statistical analysis.ResultsAbnormalities were found at concavity of muscles between AIS and controls. Significantly higher SI and fatty components was observed in AIS at MF muscles on concavity than controls (P-value <0.001). Additionally, SI at MF muscles was significantly correlated with Cobb angle.ConclusionIncreased SI and fatty components are asymmetrically present in PSM at apex in AIS. Our results showed higher intensity in PSM at concavity in AIS when compared with controls. There was a significant linear correlation between abnormal muscle signal and scoliotic curve. Above features are suggestive of altered muscle composition in concave PSM, possibly due to prolonged compression and reduced muscle activity of PSM caused by the spinal deformity.Level Of Evidence4.

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