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Purpose <p>The impact of bariatric surgery on bone density reduction has been well documented, while its effects on paraspinal muscles remain unclear. This study aims to analyze changes in muscle fatty infiltration one year after bariatric surgery in young obese adults.</p> Methods <p>A group of obese patients (obese group) and normal-weight controls (control group), both without a history of spine surgery, were included. Clinical variables including total weight loss and experimental indices were collected for the obese group. MRI-based measurements of fat fraction (FF) and cross-sectional area (CSA) of multifidus muscle (MF), erector spinae (ES), and psoas muscles, as well as T2 value of the whole disc at all disc levels were compared between groups at baseline. For the obese group, these measurements were also compared between preoperative and postoperative. Pearson correlation was used to analyze the relationship between muscle MRI parameters and weight.</p> Results <p>Fifty-two obese patients (BMI = 38.5 ± 5.6&#xa0;kg/m<sup>2</sup>, mean age = 33.15 ± 6.51 years) and 52 age- and sex-matched controls (BMI = 23.5 ± 5.6&#xa0;kg/m<sup>2</sup>, mean age = 33.52 ± 3.43 years) were included. Forty obese patients returned for one-year follow-up. At baseline, obese patients exhibited increased FF values in all three muscles and increased CSA in the ES at all disc levels (<i>P</i> &lt; 0.001). While for the MF and psoas, significant increases in CSA were observed only at L4/5 and L5/S1 disc levels (<i>P</i> &lt; 0.05). The obese group also displayed significantly lower T2 values and higher Pfirrmann classification for all five intervertebral discs (all <i>P</i> &lt; 0.05), particularly at higher levels. At follow-up, FF values of the ES and MF significantly decreased only at the L1/2-disc level (<i>P</i> &lt; 0.05). These decreases were not significantly correlated with weight loss (all <i>P</i> &gt; 0.05). However, a significant link was found between changes in high-sensitivity C-reactive protein and FF values of the ES and MF at L1/2 level from preoperative to postoperative (<i>P</i> &lt; 0.05).</p> Conclusions <p>Significant improvements in muscle fatty infiltration were observed in the ES and MF at higher levels one year postoperatively for obese patients, which may be linked to the improvements of high-sensitivity C-reactive protein.</p>

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Longitudinal variations of paraspinal muscle fatty infiltration in obese patients after bariatric surgery

  • 期刊论文

  • 发表日期：

    2025年6月11日

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  • Yuxue Xie,
  • Chongwen Zhan,
  • Hongyue Tao,
  • Qing Li,
  • Rong Hua,
  • Qiyuan Yao,
  • Qiwei Shen,
  • Shuang Chen

摘要

Purpose

The impact of bariatric surgery on bone density reduction has been well documented, while its effects on paraspinal muscles remain unclear. This study aims to analyze changes in muscle fatty infiltration one year after bariatric surgery in young obese adults.

Methods

A group of obese patients (obese group) and normal-weight controls (control group), both without a history of spine surgery, were included. Clinical variables including total weight loss and experimental indices were collected for the obese group. MRI-based measurements of fat fraction (FF) and cross-sectional area (CSA) of multifidus muscle (MF), erector spinae (ES), and psoas muscles, as well as T2 value of the whole disc at all disc levels were compared between groups at baseline. For the obese group, these measurements were also compared between preoperative and postoperative. Pearson correlation was used to analyze the relationship between muscle MRI parameters and weight.

Results

Fifty-two obese patients (BMI = 38.5 ± 5.6 kg/m2, mean age = 33.15 ± 6.51 years) and 52 age- and sex-matched controls (BMI = 23.5 ± 5.6 kg/m2, mean age = 33.52 ± 3.43 years) were included. Forty obese patients returned for one-year follow-up. At baseline, obese patients exhibited increased FF values in all three muscles and increased CSA in the ES at all disc levels (P < 0.001). While for the MF and psoas, significant increases in CSA were observed only at L4/5 and L5/S1 disc levels (P < 0.05). The obese group also displayed significantly lower T2 values and higher Pfirrmann classification for all five intervertebral discs (all P < 0.05), particularly at higher levels. At follow-up, FF values of the ES and MF significantly decreased only at the L1/2-disc level (P < 0.05). These decreases were not significantly correlated with weight loss (all P > 0.05). However, a significant link was found between changes in high-sensitivity C-reactive protein and FF values of the ES and MF at L1/2 level from preoperative to postoperative (P < 0.05).

Conclusions

Significant improvements in muscle fatty infiltration were observed in the ES and MF at higher levels one year postoperatively for obese patients, which may be linked to the improvements of high-sensitivity C-reactive protein.