Relationship of spinal alignment with muscular volume and fat infiltration of lumbar trunk muscles

PLoS One. 2018 Jul 5;13(7):e0200198. doi: 10.1371/journal.pone.0200198. eCollection 2018.


Fat infiltration and atrophy of lumbar muscles are related to spinal degenerative conditions and may cause functional deficits. Spinal alignment exerts biomechanical influence on lumbar intervertebral discs and joints. Our objective was to evaluate if spinopelvic parameters correlate with the lumbar muscle volume and fat infiltration. This is an observational, prospective and cross-sectional study. Ninety-three asymptomatic adult aged 20-40 years were included. Lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), thoracolumbar alignment (TL), sagittal vertical axis (SVA), C2-pelvic angle (CPA), spinosacral angle (SSA), lack of lordosis (PI-LL), L1S1 and T1S1 length were measured on panoramic spine radiographs. Lumbar axial T1-weighted and In- and Out-Phase images were obtained on 1.5T MRI scanner and were used to extract the muscle volumes and fat fractions of multifidus, erector spinae, and psoas. All muscle volumes were higher in men than women (p<0.05). The fat fraction was higher in the multifidus and erector spinae in women (p<0.05). Multifidus volume was weakly correlated with PT (R = 0.22), PI (R = 0.22), LL (R = 0.34) and CPA (R = 0.29). Erectors spinae volume were correlated with CPA (R = 0.21). Psoas volume correlated with TK (R = 0.21), TL (R = 0.27) and SVA (R = -0.23). The lumbar muscle volumes showed a moderated correlation with T1S1 length (R = 0.55 to 0.62). Spinopelvic parameters showed correlation with lumbar muscle volumes but not with muscle fat infiltration on asymptomatic young adults.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adipose Tissue / physiology*
  • Adult
  • Body Fat Distribution
  • Cross-Sectional Studies
  • Female
  • Healthy Volunteers
  • Humans
  • Kyphosis / diagnostic imaging
  • Lordosis / diagnostic imaging
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbosacral Region / diagnostic imaging
  • Male
  • Muscle, Skeletal / anatomy & histology
  • Muscle, Skeletal / physiology*
  • Pelvis / diagnostic imaging
  • Prospective Studies
  • Retrospective Studies
  • Sacrum / diagnostic imaging
  • Spinal Curvatures / diagnostic imaging
  • Spine / physiology*
  • Thoracic Vertebrae / diagnostic imaging

Grant support

This work was supported by the CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico (process 473688/2012-3) grant funds to purchase equipment, preparation of scientific material and participation in conferences ( and FINEP (process 01/2006, Ref. 0184/07) grants funds for realization of magnetic resonance imaging ( and CAPES grants scholarships for post-graduation students, 01500990612 ( The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.