Asymmetrical radiological changes in the Paraspinal muscles in patients with idiopathic scoliosis: Prospective study

Objectives: The aim of this study is to assess the CT and MRI appearance of theparaspinous muscles in patients with idiopathic scoliosis comparing both the convex and concave sides of the curve. The relation between the degrees of muscular abnormality and the Cobb angle is also assessed. Methods: 18 patients with idiopathic scoliosis were referred to Mansoura university hospital clinics in the period from September 2015 to February 2017. This observational prospective study includes patients with idiopathic scoliosis. Patients with secondary scoliosis due to other abnormalities were not included in this study. Verbal consent was obtained from the patient’s parents and institutional Board review acceptance at Mansoura University was done. Results: Both MRI and CT demonstrated the atrophy of the paraspinous muscles in patients with AIS in the form of reduction in the size of the muscle fibers, T1 & T2 hyperintenities within the muscle fibers by MRI and low density within the muscles fibers by CT as well as widening of the fatty spaces between the muscle bundles. Assessing the paraspinal muscles along the whole spine, we found that in all patients, the atrophic changes were more pronounced at the apex of the curve. Conclusion: CT and MRI are effective non-invasive modalities to assess the changes in the paraspinal muscles. They demonstrate atrophic changes and fatty degeneration of the paraspinal muscles, more evident at the concave side of the apex of the primary curve. The degree of fatty degeneration is proportional with the Cobb’s angle.