Risk Factors of Multifidus Muscle Fat Infiltration in Patients with Single-segment (L4-5) Degenerative Lumbar Spinal Stenosis：A retrospective cohort study

Risk Factors of Multifidus Muscle Fat Infiltration in Patients with Single-segment (L4-5) Degenerative Lumbar Spinal Stenosis：A retrospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Risk Factors of Multifidus Muscle Fat Infiltration in Patients with Single-segment (L4-5) Degenerative Lumbar Spinal Stenosis：A retrospective cohort study Jianshi Yin, Dan Liu, Weimin Huang, Xiaoduo Xu, Lei Wang, Yanguo Zhang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8214066/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Study design: A retrospective cohort study Objective :To investigate the risk factors for multifidus muscle (MF) fat infiltration in patients with L4-5 degenerative lumbar spinal stenosis (DLSS). Methods :A total of 118 surgical patients diagnosed with single-segment (L4-5) DLSS between January 2019 and February 2023 were retrospectively enrolled. MF fat infiltration at the L4-5 level was evaluated on T2-weighted MRI using the Kjaer scale. Facet joint degeneration (Grade 0–3) was assessed using the Weishaupt classification on CT, and spinal canal stenosis severity (Grade 1–3) was rated with the Lee classification on MRI. Univariate and multivariate ordinal logistic regression analyses were performed to identify risk factors. Results :The patients had a mean age of 61.43±8.63 years, with 66.95% being female. Multivariate analysis showed that female gender (P<0.001, OR = 5.00, 95% CI: 2.03 ~ 12.32), older age (P=0.003, OR = 1.08, 95% CI: 1.03 ~ 1.14), L4 spondylolisthesis (P=0.034, OR = 2.75, 95% CI: 1.08 ~ 7.01), severe facet joint degeneration (P=0.040, OR = 6.60, 95% CI: 1.09-39.78), and severe spinal canal stenosis (P=0.001, OR = 5.90, 95% CI: 1.99 ~ 17.48) were independent risk factors for aggravated MF fat infiltration. Conclusion :In patients with single-segment (L4-5) DLSS, female gender, older age, degenerative spondylolisthesis, severe facet joint degeneration, and severe spinal canal stenosis are independent risk factors for aggravated MF fat infiltration, with severe spinal canal stenosis exhibiting the strongest risk effect. Multifidus muscle Fat infiltration Degenerative lumbar spinal stenosis Risk factors Cross-sectional study Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 09 Feb, 2026 Reviewers agreed at journal 26 Jan, 2026 Reviewers invited by journal 21 Jan, 2026 Editor invited by journal 01 Dec, 2025 Editor assigned by journal 27 Nov, 2025 Submission checks completed at journal 27 Nov, 2025 First submitted to journal 26 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8214066","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":578262862,"identity":"17ae631c-5dc8-489d-bf73-4cfec945bcc1","order_by":0,"name":"Jianshi Yin","email":"","orcid":"","institution":"967th Hospital of PLA","correspondingAuthor":false,"prefix":"","firstName":"Jianshi","middleName":"","lastName":"Yin","suffix":""},{"id":578262863,"identity":"be284040-174d-48e5-98ab-f103c1a26862","order_by":1,"name":"Dan Liu","email":"","orcid":"","institution":"Kunming Medical 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study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Multifidus muscle, Fat infiltration, Degenerative lumbar spinal stenosis, Risk factors, Cross-sectional study","lastPublishedDoi":"10.21203/rs.3.rs-8214066/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8214066/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eStudy design: \u003c/strong\u003eA retrospective cohort study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e:To investigate the risk factors for multifidus muscle (MF) fat infiltration in patients with L4-5 degenerative lumbar spinal stenosis (DLSS).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e:A total of 118 surgical patients diagnosed with single-segment (L4-5) DLSS between January 2019 and February 2023 were retrospectively enrolled. MF fat infiltration at the L4-5 level was evaluated on T2-weighted MRI using the Kjaer scale. Facet joint degeneration (Grade 0–3) was assessed using the Weishaupt classification on CT, and spinal canal stenosis severity (Grade 1–3) was rated with the Lee classification on MRI. Univariate and multivariate ordinal logistic regression analyses were performed to identify risk factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e:The patients had a mean age of 61.43±8.63 years, with 66.95% being female. Multivariate analysis showed that female gender (P\u0026lt;0.001, OR = 5.00, 95% CI: 2.03 ~ 12.32), older age (P=0.003, OR = 1.08, 95% CI: 1.03 ~ 1.14), L4 spondylolisthesis (P=0.034, OR = 2.75, 95% CI: 1.08 ~ 7.01), severe facet joint degeneration (P=0.040, OR = 6.60, 95% CI: 1.09-39.78), and severe spinal canal stenosis (P=0.001, OR = 5.90, 95% CI: 1.99 ~ 17.48) were independent risk factors for aggravated MF fat infiltration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e:In patients with single-segment (L4-5) DLSS, female gender, older age, degenerative spondylolisthesis, severe facet joint degeneration, and severe spinal canal stenosis are independent risk factors for aggravated MF fat infiltration, with severe spinal canal stenosis exhibiting the strongest risk effect.\u003c/p\u003e","manuscriptTitle":"Risk Factors of Multifidus Muscle Fat Infiltration in Patients with Single-segment (L4-5) Degenerative Lumbar Spinal Stenosis：A retrospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-23 18:23:15","doi":"10.21203/rs.3.rs-8214066/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-09T06:42:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"8768988006513775632657772615282813052","date":"2026-01-26T22:36:49+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-21T16:00:25+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-01T10:57:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-27T14:10:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-27T14:08:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Musculoskeletal Disorders","date":"2025-11-26T14:25:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8819b5cf-f677-41c1-9e52-71a24cbf7964","owner":[],"postedDate":"January 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-23T18:23:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-23 18:23:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8214066","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8214066","identity":"rs-8214066","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}