The following is the summary of “Effect of Paraspinal Fatty Muscle Infiltration and Cumulative Lumbar Spine Degeneration on the Outcome of Patients With Lumbar Spinal Canal Stenosis: Analysis of the Lumbar Stenosis Outcome Study (LSOS) Data” published in the January 2023 issue of Spine by Getzmann, et al.

The study design is Prospective. The purpose of this study was to examine the relationship between paraspinal fatty muscle infiltration (FMI) and cumulative lumbar spine degeneration (as measured by magnetic resonance imaging) on long-term clinical outcome measures in patients with lumbar spinal canal stenosis (LSCS) from the Lumbar Stenosis Outcome Study (LSOS) cohort. Prior research has attempted to link morphologic imaging results in LSCS to clinical outcomes. Nonetheless, the relationship between FMI and cumulative degenerative stress on the lumbar spine has yet to be studied extensively. Therefore, patients with moderate to severe LSCS from the LSOS cohort were considered. 

The severity of LSCS and total lumbar spine degeneration was evaluated by 2 radiologists. The Goutallier scale was utilized to evaluate FMI. The severity of symptoms and disability was evaluated using the Spinal Stenosis Measure (SSM). In addition, the health-related quality of life was measured with the European Quality of Life Scale 5 Dimensions 3 Levels of Implementation (EQ-5D-3L). There were 116 patients (age 74.8 ±8.5 yr) in the nonsurgical treatment group and 300 patients (age 72.3± 8.2 yr) in the surgical treatment group. There was a statistically significant difference in the prevalence of paraspinal FMI between the 2 groups (54.3% vs. 32.0% for Goutallier grade ≥2; P=0.001). 

Scores for total degeneration were similar between the two groups (9.5±2.0 vs. 9.3±2.0; P=0.418). Lower SSM function and the EQ-5D-3L were both linked with FMI (all P<0.05), although SSM symptoms were not. Neither SSM symptoms nor SSM function nor EQ-5D-3L was correlated with total degeneration of the lumbar spine (all P>0.05). Patients in the LSOS cohort who have LSCS and are overweight or obese had more impairment and a lower health-related quality of life. Total cumulative lumbar spine deterioration did not correlate with outcomes for patients who underwent surgery or those who did not.