{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:53:02Z","timestamp":1785775982980,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spondylolisthesis is a frequently encountered condition in orthopedics, requiring dynamic stability maintained primarily by the paraspinal muscles. This systematic review evaluates the cross\u2010sectional area (CSA) and fat infiltration (FI) of paraspinal muscles\u2014specifically the multifidus, erector spinae, and psoas major\u2014in lumbar spondylolisthesis (LS) to understand their roles in spinal stability and progression in degenerative and isthmic forms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, PubMed, Cochrane, and Scopus were searched as of September 2024. Fourteen retrospective studies using MRI\/CT imaging met inclusion criteria, focusing on CSA and FI in LS. Data were extracted from studies that assessed spinal instability through vertebral slippage measurements or comparisons with asymptomatic controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings indicate that reduced CSA and increased FI in paraspinal muscles, especially the multifidus, are associated with spinal instability and progressive vertebral slippage. Several studies reported reductions in CSA and increases in FI in patients with spondylolisthesis, although methods and anatomical levels varied across studies. Compensatory hypertrophy of the erector spinae and psoas major was observed, particularly in isthmic cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings support the potential role of muscle health in maintaining spinal stability and suggest that targeted rehabilitation strategies addressing paraspinal muscle alterations may improve clinical outcomes in patients with LS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70362","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T03:13:21Z","timestamp":1784085201000},"page":"1563-1573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic Review of Paraspinal Muscle Changes in Lumbar Spondylolisthesis:\n                    <scp>MRI<\/scp>\n                    and\n                    <scp>CT<\/scp>\n                    Insights"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3583-7563","authenticated-orcid":false,"given":"Valerio","family":"D'Andrea","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Radiology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"},{"name":"Casa di Cura Villa Stuart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Bernetti","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Radiology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Greco","sequence":"additional","affiliation":[{"name":"Research Unit of Radiology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"},{"name":"Department of Radiology Cittadella Della Salute Azienda Sanitaria Locale di Lecce  Lecce Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Volterrani","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Radiology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo C.","family":"Quattrocchi","sequence":"additional","affiliation":[{"name":"Centre for Medical Sciences\u2010CISMed, University of Trento  Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Parizel","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital (RPH)  Perth Australia"},{"name":"Medical School, University of Western Australia (UWA)  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Van Goethem","sequence":"additional","affiliation":[{"name":"Department of Radiology Antwerp University Hospital  Edegem Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Di Gennaro","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Chair of Medical Statistics, University of Catanzaro \u201cMagna Gr\u00e6cia\u201d  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Beomonte","family":"Zobel","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Radiology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo A.","family":"Mallio","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Radiology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome 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