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Updated: May 2, 2026

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Abdominal Aortic Calcification Is Associated With Degeneration of The Paraspinal Muscles: A Retrospective
Friederike Schömig1,2, Lukas Schönnagel1,2, Jiaqi Zhu3
1Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY.
Study Design:
Retrospective cohort study.
Objective:
The aim of this study was to analyze the relationship of abdominal aortic calcification (AAC) and a reduction in the cross-sectional area (CSA) and the fatty infiltration (FI) of the paravertebral muscles in patients undergoing lumbar fusion surgery.
Background:
Both AAC and paraspinal muscle degeneration have been shown to be associated with poorer outcomes after surgical treatment of degenerative diseases of the lumbar spine. However, there is a lack of data on the association between AAC and paraspinal muscle changes in patients undergoing spine surgery.
Methods:
We retrospectively analyzed patients undergoing lumbar fusion for degenerative spinal pathologies. Muscular and spinal degeneration were measured on magnetic resonance imaging (MRI). AAC was classified on lateral lumbar radiographs. The association of AAC and paraspinal muscle composition was assessed by a multivariate regression analysis adjusted for age, sex, body mass index (BMI), comorbidities, and lumbar degeneration.
Results:
A total of 301 patients was included. Patients with AAC showed significantly higher degrees of intervertebral disk and facet joint degeneration as well as higher total endplate scores at the L3/L4 level. The univariable regression analysis showed a significant positive correlation between the degree of AAC and the FI of the erector spinae ( b =0.530, P <0.001) and multifidus ( b =0.730, P <0.001). The multivariable regression analysis showed a significant positive correlation between the degree of AAC and the FI of the erector spinae ( b =0.270, P =0.006) and a significant negative correlation between the degree of AAC and the CSA of the psoas muscle ( b =-0.260, P =0.003).
Conclusions:
This study demonstrates a significant and independent association between AAC and degeneration of the erector spinae and the psoas muscles in patients undergoing lumbar fusion. As both AAC and degeneration of paraspinal muscles impact postoperative outcomes negatively, preoperative assessment of AAC may aid in identifying patients at higher risk after lumbar surgery.
Level Of Evidence:
Level III.
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