Computed tomography of paraspinal musculature in ankylosing spondylitis

Computed tomography (CT) was used to delineate the paraspinal musculature in 14 patients with ankylosing spondylitis (AS). Abnormal atrophy of the erector spinae muscles and multifidi was demonstrated in all 8 patients with total bony ankylosis of the spine, but was not present in those with isolated syndesmophyte formation, vertebral squaring alone or sacroiliac joint ankylosis with normal spinal radiographs. There was a significant positive correlation between a CT score of paravertebral muscle wasting and clinical parameters of disease duration and restriction of spinal mobility. Wasting and asymmetry of the psoas muscles was seen in 3 patients with unilateral hip joint involvement. These findings suggest that a relationship exists between decreased or absent spinal movement and atrophy of the paraspinal musculature in AS.