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Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

Xiexiang Shao, Jian Chen, Jingfan Yang, Wenyuan Sui, Yaolong Deng, Zifang Huang, Ping Hu, Junlin Yang

Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)

Med Sci Monit 2020; 26:e924415

DOI: 10.12659/MSM.924415

Available online: 2020-06-03

Published: 2020-07-30

BACKGROUND: Paraspinal muscle (PSM) has been suggested to have a role in adolescent idiopathic scoliosis (AIS). Few studies have investigated the fiber type-specific changes of PSM in detail.
MATERIAL AND METHODS: Bilateral multifidus muscles were harvested from the apical vertebra level (T7-T10) of 12 AIS patients and 6 control individuals. Immunohistological staining was performed to evaluate the muscle fiber type composition, fiber type-specific cross-sectional area (CSA), myonuclei density, and the total and activated satellite cell (SC) density. The correlations between these characteristics and curve initiation/severity were analyzed.
RESULTS: In comparison with the PSM in convexity and the control group, PSM in concavity showed a significant reduction of CSA (concavity, 2601.1±574.1 μm²; convexity, 3732.1±545.1 μm²; control, 3426.5±248.4 μm²), myonuclei density (concavity, 2.0±0.3 myonuclei/fiber; convexity, 2.5±0.4 myonuclei/fiber; control, 2.2±0.2 myonuclei/fiber), and activated SC density (concavity, 0.7±0.4 cells/100 fibers; convexity, 1.5±0.7 cells/100 fibers; control, 1.2±0.3 cells/100 fibers) for fiber type I. The Cobb angle was positively correlated with the bilateral ratio of CSA (convexity/concavity) for both fiber types. The apical vertebral translation was positively correlated with bilateral difference of myonuclei density (type I), total SC density (types I and II), and activated SC density (type I).
CONCLUSIONS: The fiber type-specific pathological changes on the concave side seemed to be more severe. Some fiber type-specific characteristics (CSA, myonuclei density, total/activated SC density) were closely associated with curve severity. More attention should be paid to PSM physiotherapy treatment on the concave side.

Keywords: Biopsy, Fluorescent Antibody Technique, Paraspinal Muscles, Satellite Cells, Skeletal Muscle, Scoliosis