The Association of Vascular Health With Cervical Paraspinal Muscle Atrophy and Disc Degeneration

Study DesignRetrospective cross-sectional.ObjectiveDegeneration of paraspinal muscles and intervertebral discs has been associated with adverse outcomes. While vascular influences on lumbar degeneration are known, cervical associations remain unclear. The objective is to evaluate the relationship between carotid artery stenosis (CAS) and cervical paraspinal muscle atrophy as well as its association with intervertebral disc integrity.MethodsPatients undergoing primary cervical spine surgery (2009-2018) with cervical MRI and CTA ≤12 months apart were included. MRIs from C3-C7 quantified fatty infiltration (FI) and functional cross-sectional area (fCSA) in sternocleidomastoid (SCM), anterior group (AG), scalenus (SN), posteromedial (PM), posterolateral (PL), and trapezius (TP) groups. Disc degeneration was evaluated using the Disc Signal Intensity score. Maximum and mean CAS were measured on CTA.ResultsSixty-five patients were included. In multivariable linear regression models, higher mean stenosis was significantly associated with increased FI in multiple muscle groups at C3, as well as the PM at C4 and SCM at C5 (P < 0.05), and with reduced fCSA in the PM and SCM at C4 (P < 0.05). Higher maximum stenosis was associated with increased FI in the SCM and TP at C3 and the PL at C4, along with reduced fCSA in the SCM at C4 (P < 0.05). No significant associations were observed with disc degeneration.ConclusionCAS was associated with cervical muscle atrophy, suggesting a potential link with vascular health. In contrast, disc degeneration showed no association with CAS, suggesting that muscle atrophy and disc degeneration may follow distinct pathways.