Research Progress on the Correlation Between Lumbar Paraspinal Muscle Fat Infiltration and Degenerative Lumbar Spondylolisthesis

Degenerative Lumbar Spondylolisthesis (DLS) is a common spinal degenerative disease that leads to low back pain and leg dysfunction in middle-aged and elderly people. In recent years, more and more attention has been paid to the functional status and morphological changes of lumbar paraspinal muscles, especially multifidus muscles, in the occurrence and development of DLS. As the core pathological feature of paraspinal muscle degeneration, fat infiltration is closely related to the severity, clinical symptoms and prognosis of DLS. This article aims to systematically review the imaging evaluation methods of fat infiltration, its correlation with DLS clinical and imaging parameters, potential interaction mechanisms (including the vicious cycle of inflammation, abnormal innervation, biomechanical imbalance and fat metabolism disorders), and new clinical treatment strategies based on muscle evaluation. Current evidence shows that paraspinal muscle fat infiltration is not only the result of DLS, but also actively participates in the progression of the disease. Therefore, in clinical diagnosis and treatment, it is of great significance to include the status of paraspinal muscles in the evaluation system and explore targeted muscle rehabilitation and protection strategies for improving the prognosis of DLS patients.