Quantitative MRI assessment of multifidus and erector spinae fatty degeneration in Parkinson's disease patients with lumbar degenerative disease: a propensity score-matched study.

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ObjectiveThis study aims to elucidate the characteristics of the multifidus and erector spinae muscles in patients suffering from lumbar degenerative diseases (LDD) complicated by Parkinson's disease (PD), through a comparative analysis with LDD patients who do not have PD.MethodsSeventeen patients with LDD accompanied by PD (case group) and 17 patients with LDD without PD (control group) were enrolled through propensity score matching (1:1) from January 2020 to January 2025. All participants underwent 1.5T lumbar MRI, and the semi-quantitative intramuscular fat-infiltration index (SIFI) and cross-sectional area (CSA) of the multifidus and erector spine muscles at the L3/4 and L4/5 levels were measured separately at each level.ResultsThe semi-quantitative intramuscular fat-infiltration index (SIFI) values of multifidus (66.19 ± 14.03) and erector spinae (73.54 ± 11.76) averaged across L3/4 and L4/5 level in the case group were significantly higher than those in the control group (56.63 ± 4.84 and 53.34 ± 5.90, all P P > 0.05). Additionally, the erector spinae exhibited greater fat infiltration than the multifidus in patients with PD, with no evidence of bilateral asymmetry or segmental predominance.ConclusionCompared to LDD patients without PD, those with PD exhibit more severe fat infiltration in both the multifidus and erector spinae, primarily affecting the erector spinae. This fat infiltration compromises spinal stability, postural maintenance, and motor control, potentially contributing to spinal complications such as camptocormia. These findings suggest a potential therapeutic target for clinical intervention.

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