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中华损伤与修复杂志(电子版) ›› 2026, Vol. 21 ›› Issue (05) : 378 -383. doi: 10.3877/cma.j.issn.1673-9450.2026.05.008

综述

中老年人L3层面椎旁肌CT定量评估的研究进展
关连鹏1, 段芳芳2, 王玲3, 刘亚军1,4,†()   
  1. 1 250117 济南,山东第一医科大学公共卫生与管理学院
    2 100035 首都医科大学附属北京积水潭医院临床流行病学研究室
    3 100035 首都医科大学附属北京积水潭医院放射科
    4 100035 首都医科大学附属北京积水潭医院脊柱外科
  • 收稿日期:2026-07-17 出版日期:2026-10-01
  • 通信作者: 刘亚军
  • 基金资助:
    首都卫生发展科研专项(2024-1-1121); 北京市医院管理中心“登峰”人才培养计划(DFL20220401)

Advances in CT-based quantitative assessment of paraspinal muscles at the L3 level in middle-aged and older adults

Lianpeng Guan1, Fangfang Duan2, Ling Wang3, Yajun Liu1,4,†()   

  1. 1 School of Public Health and Management,Shandong First Medical University,Jinan 250117,China
    2 Department of Epidemiology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China
    3 Department of Radiology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China
    4 Department of Spine Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China
  • Received:2026-07-17 Published:2026-10-01
  • Corresponding author: Yajun Liu
引用本文:

关连鹏, 段芳芳, 王玲, 刘亚军. 中老年人L3层面椎旁肌CT定量评估的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2026, 21(05): 378-383.

Lianpeng Guan, Fangfang Duan, Ling Wang, Yajun Liu. Advances in CT-based quantitative assessment of paraspinal muscles at the L3 level in middle-aged and older adults[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2026, 21(05): 378-383.

随着人口老龄化及腹部CT检查的广泛应用,利用既有影像开展骨骼肌机会性评估日益受到关注。椎旁肌是腰椎主动稳定系统的重要组成部分,参与维持脊柱节段稳定、姿势控制和负荷传递。随着年龄增长,椎旁肌可出现肌肉萎缩、CT衰减值降低和脂肪浸润增加,其结构和组织构成变化与腰痛、腰椎退行性改变及功能受限相关。第3腰椎(L3)层面通常位于腹部CT扫描范围内,定位相对明确。L3层面后方椎旁肌(以下简称L3层面椎旁肌)的横截面积、平均CT衰减值及脂肪浸润等指标,可从肌肉量和组织构成等方面反映中老年人局部肌肉退变。该文围绕L3层面椎旁肌的解剖界定、CT定量指标、扫描与分割方法及其标准化要求进行综述,归纳相关指标的年龄、性别和体型差异,梳理其与腰痛、腰椎退行性改变及骨量指标的关联证据,并探讨其在中老年人风险识别和机会性评估中的潜在价值,以期为规范L3层面椎旁肌CT定量评估、促进多中心研究结果比较及临床转化提供参考。

With population aging and the widespread use of abdominal CT,opportunistic assessment of skeletal muscle using existing imaging data has received increasing attention. The paraspinal muscles are an important component of the active stabilizing system of the lumbar spine and contribute to segmental stability,postural control,and load transmission. With advancing age,these muscles may exhibit atrophy,reduced CT attenuation,and increased fatty infiltration; changes in their structure and tissue composition have been associated with low back pain,lumbar degenerative changes,and functional impairment. The third lumbar vertebral (L3) level is generally included in abdominal CT scans and can be readily identified. At this level,the cross-sectional area,mean CT attenuation,and fatty infiltration of the posterior paraspinal muscles (hereafter referred to as the L3-level paraspinal muscles) may reflect local muscle degeneration in terms of muscle quantity and tissue composition in middle-aged and older adults. This review summarizes the anatomical definition of the L3-level paraspinal muscles,CT-based quantitative parameters,scanning and segmentation methods,and requirements for methodological standardization; describes age-,sex-,and body size-related differences in these parameters; reviews evidence regarding their associations with low back pain,lumbar degenerative changes,and bone mass parameters; and discusses their potential value in risk identification and opportunistic assessment. It aims to provide a reference for standardizing CT-based quantitative assessment of the L3 paraspinal muscles,facilitating comparisons across multicenter studies,and promoting clinical translation.

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