This cross-sectional study aims to investigate the relationship between MRI-based paraspinal muscle fatty degeneration, bone mineral density (BMD), and sarcopenia parameters in postmenopausal women. A total of 100 participants aged 60-80 years will be included. Lumbar paraspinal fatty infiltration will be evaluated both qualitatively using the Goutallier classification and quantitatively using ImageJ software to calculate muscle area, fat area, fat ratio, and functional muscle area.

BMD and T-scores of the lumbar spine (L1-L4) and femoral neck will be measured using dual-energy X-ray absorptiometry (DXA). Sarcopenia will be diagnosed based on EWGSOP2 criteria, including muscle mass (assessed by bioelectrical impedance analysis), handgrip strength, and physical performance tests (gait speed, SPPB, TUGT, and 5STS). Sarcopenia-specific quality of life will be assessed using the Sarcopenia Quality of Life Questionnaire (SarQoL-TR).

The study aims to clarify the associations among paraspinal muscle quality, bone health, and sarcopenia, providing a comprehensive understanding of muscle-bone interactions in postmenopausal women. Findings may support the use of paraspinal muscle evaluation as a complementary marker in the management of sarcopenia and osteoporosis.

Inclusion Criteria:

• Female participants aged 60-80 years
• Postmenopausal status
• Lumbar MRI and DXA scan performed within the past six months
• Willingness to participate and ability to provide written informed consent

Exclusion Criteria:

• History of lumbar spine surgery (e.g., laminectomy, stabilization)
• Pfirrmann grade ≥4 lumbar disc degeneration on MRI¹³
• Secondary osteoporosis or Paget's disease
• Use of walking aids or mobility restrictions
• Neurological or systemic disorders affecting movement, including:
• Parkinson's disease
• Stroke
• Amyotrophic lateral sclerosis (ALS)
• Central or peripheral vertigo
• Severe immobility or inability to complete performance tests
• Presence of a hip prosthesis

postmenopausal women aged 60-80 years