muscle atrophy after spinal fusion

Back pain and disability after lumbar laminectomy: is there a relationship to muscle retraction? Epub 2023 Mar 31. Article Min et al. Spinal muscular atrophy (SMA) refers to a group of hereditary diseases that can damage and kill specialized nerve cells in the brain and spinal cord (motor neurons). Supplementary information accompanies this paper at 10.1186/s12891-020-3051-9. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. -, Fan S, Hu Z, Zhao F, Zhao X, Huang Y, Fang X. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. Hu et al. How Can HGH Be Helpful For Surgery? This study was approved by Chang Gung Memorial Hospitals institution review board and all methods were performed in accordance with the relevant guidelines (approval no. Several studies have shown that fatty infiltration in the paraspinal muscles is more prominent in the lower lumbar segments in asymptomatic persons18,19. Radiol. Skelet. Sci Rep 10, 14635 (2020). Sci. & Swedish Lumbar Spine Study, G. Chronic low back pain and fusion: A comparison of three surgical techniques: A prospective multicenter randomized study from the Swedish lumbar spine study group. FOIA Perez-Orribo L, Kalb S, Reyes PM, Chang SW, Crawford NR. In particular, the extensor muscle of the lower lumber part plays a vital role in maintaining the balance of the lumbar levels and is also a dynamic stabilizer for the movement of the spine-pelvis complex. A large number of non-muscle tissues (high signal area in the blue circle) occupying the original muscle position 2years after surgery. Accessibility The site is secure. Kim, D. Y., Lee, S. H., Chung, S. K. & Lee, H. Y. Complications include significant perioperative bleeding, dural tear, and postoperative muscular atrophy caused by denervation during surgery [8, 9]. Several studies have compared postoperative paraspinal muscle degeneration occurring after COS and MIS using MRI or computed tomography (CT) (Table 2)1,3,9,10,11,12,13,14,15. Rhee JM, Schaufele M, Abdu WA. Muscle Atrophy. Oblique lateral interbody fusion (OLIF) was first introduced in 2012 [10]. Although the paraspinal muscles play an important role in spine stability, no study has assessed the relationship between paraspinal muscle atrophy and the incidence of ASD after lumbar fusion. Accordingly, Hu et al. 4). We believe that strong fixation results in a long-term disuse paraspinal muscle atrophy and further accelerate the degeneration of adjacent segments. Article For this reason, we performed the follow-up MRI evaluations at approximately 1year after surgery, and used T1-weighted images for MFI qualification18. Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE. There were no differences in FCSA and FIP between OLIF (n=32) and OLIF+PPSF (n=41) groups before surgery. Conversely, regression analysis showed a negative correlation between MF muscle volume loss and age in the MRI group (right and left, p = 0.002 and p = 0.015, respectively), that is, the younger the age, the greater loss of muscle mass. Acute lumbar disk pain: navigating evaluation and treatment choices. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. https://doi.org/10.1007/s00586-009-1191-6 (2010). Spine (Phila Pa 1976). Paraspinal muscular atrophy (PMA) after dorsomedian approach is a common complication of spinal surgery [1]. Increased intramuscular fatty infiltration without differences in lumbar muscle cross-sectional area during remission of unilateral recurrent low back pain. The replacement of lean muscle by a fatty component suggests a decreased contractile muscle component and fatty degeneration of the muscle. Kepler CK, Yu AL, Gruskay JA, Delasotta LA, Radcliff KE, Rihn JA, Hilibrand AS, Anderson DG, Vaccaro AR. Federal government websites often end in .gov or .mil. All patients were operated by surgeons who had >20years of experience in spinal surgery. https://doi.org/10.1097/BSD.0000000000000038 (2017). There was no significant difference in adjacent segment degeneration in the standalone OLIF group after surgery. Preoperative clinical symptoms included low back pain, sciatica, and variable neurological symptoms. Spine J. The high incidence of paravertebral lumbar muscle injury after open techniques have raised the attention of surgeons for less morbid approaches. Strube P, Putzier M, Streitparth F, Hoff EK, Hartwig T. Postoperative posterior lumbar muscle changes and their relationship to segmental motion preservation or restriction: a randomized prospective study. Kim DY, Lee SH, Chung SK, Lee HY. Datta G, Gnanalingham KK, Peterson D, Mendoza N, O'Neill K, Van Dellen J, et al. doi: 10.1097/BRS.0b013e3181a9d28e. 19, 316324. Your surgeon will then weld together 2 or more of your vertebrae, using bone or some other artificial material. Correlation between surgical segment mobility and paravertebral muscle fatty infiltration of upper adjacent segment in single-segment LDD patients: retrospective study at a minimum 2 years' follow-up. The white arrow indicates the pedicle screw. Spinal muscle atrophy (SMA; also known as spinal muscular atrophy) is an autosomal recessive hereditary disease characterized by progressive hypotonia and muscular weakness. But 4 patients were excluded due to they did not complete the follow up MRI (2 patient suffered from other medial disease and 2 lost of follow up) (Fig. According to previous studies and the results of the present study, regarding the development or progression of adjacent-segment degeneration, we think that it may be predominantly related to muscle atrophy as well as over-rigid fixation. Urrutia, J. et al. Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. The functional scores (visual analogue scale [VAS] pain score, Oswestry Disability index [ODI], and Japanese Orthopedic Association [JOA] score) are collected pre-operation and 1year post-operation. The average improvement of DSCSA postoperatively was significantly greater in the COS group (128.1539.83mm2) compared to the MIS group (78.1538.5mm2) (P=0.0005) (Fig. https://doi.org/10.1007/s00586-009-1191-6, https://doi.org/10.1016/j.spinee.2016.05.008, https://doi.org/10.1016/j.math.2012.06.007, https://doi.org/10.1016/j.crad.2004.08.013, https://doi.org/10.3928/01477447-20160129-07, https://doi.org/10.1097/BSD.0000000000000038, https://doi.org/10.1016/j.surneu.2007.04.021, https://doi.org/10.1097/01.bsd.0000193820.42522.d9, https://doi.org/10.3346/jkms.2007.22.4.646, https://doi.org/10.1007/s00586-011-2146-2, https://doi.org/10.1097/BRS.0b013e3181a9d28e, https://doi.org/10.1016/j.spinee.2016.08.001, https://doi.org/10.1097/BRS.0b013e31805471fe, https://doi.org/10.1007/s00256-018-2902-z, https://doi.org/10.3171/2014.4.SPINE13420, https://doi.org/10.1007/s00586-017-5280-7, http://creativecommons.org/licenses/by/4.0/, Correlation between surgical segment mobility and paravertebral muscle fatty infiltration of upper adjacent segment in single-segment LDD patients: retrospective study at a minimum 2 years follow-up, Oblique lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative disease of the lumbar spine: a systematic review and meta-analysis, Lyophilized bovine acellular tendon linear fiber material for the reconstruction of attachment structure of paraspinous muscles: an animal in vivo study, The effect of posterior lumbar dynamic fixation and intervertebral fusion on paraspinal muscles. Provided by the Springer Nature SharedIt content-sharing initiative, Journal of Materials Science: Materials in Medicine (2022). PMID: 17108469 Abstract Posterior lumbar spinal fusion is a common surgery of spine. Bethesda, MD 20894, Web Policies In addition, no patient occurred implant migration in either group. While muscle atrophy is also correlated with a worse clinical outcome, it seems to be a determining factor for successful lumbar spine surgery. The mean age of the patients was 59.6 12.1 years and 32 (80.5%) were female. These better clinical outcomes were probably associated with the better FCSA, and FIP found in the standalone OLIF group compared with the OLIF combined group. Therefore, we believe that an increase in the fat percentage in the paravertebral muscle is another important factor in accelerating muscle atrophy after fusion. Hyun SJ, Kim YB, Kim YS, Park SW, Nam TK, Hong HJ, et al. Paraspinal muscle, facet joint, and disc problems: risk factors for adjacent segment degeneration after lumbar fusion. This study aimed to identify changes in back muscle atrophy between the two surgeries. sharing sensitive information, make sure youre on a federal 3, 8995. For this reason, we used the MFI to reflect the degree of fatty infiltration in the paraspinal muscles5,6. B., Nam, T. K. & Lee, Y. S. The fatty degeneration of lumbar paraspinal muscles on computed tomography scan according to age and disc level. Avoiding nearby fat, bony structures, and other soft tissues, the region of interest (ROI) was drawn with an electronic pencil. . The psoas muscle showed no significant change after 1 year. Figure3 shows an iatrogenic muscle injury. Degeneration of the adjacent segment was examined at 2years after surgery. This phenomenon is called muscle atrophy, the wasting and decrease in size of muscle tissue. Disclaimer. 2012, 325095. https://doi.org/10.1155/2012/325095 (2012). official website and that any information you provide is encrypted [28] also reported that the muscle retraction time influences the postoperative back muscle function. Muscle atrophy can involve a single muscle or can involve all of the musculature of a single extremity. The mean signal intensity (SI) in the ROI of the target muscle and fat was obtained for calculating the MFI. Thank you for visiting nature.com. https://doi.org/10.1016/j.spinee.2016.08.001 (2017). SMA is a disease that's passed down through families. Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3-4 fixation. There was a trend of more severe fatty degeneration of the paraspinal muscles after COS than MIS. Kim KT, Lee SH, Suk KS, Bae SC. Spine. 30, E162E168. Scientific Reports (Sci Rep) History of osteoporosis (defined as T-score<2.5) was verified from the medical charts. 60, 355363. Mehren C, Mayer HM, Zandanell C, Siepe CJ, Korge A. All authors read and approved the final manuscript. Complications and prevention strategies of oblique lateral Interbody fusion technique. The complete fusion was determined to be achieved if visible interbody osseous bridge had formed around the cage, no radiolucent line between the cage and endplate, and no motion on the dynamic flexion extension radiographs. The volume of the paraspinal muscles was calculated using a simple formula which was derived from the formula for calculating the volume of truncated elliptic cones. There was significantly higher postoperative PMA with lumbar spine fusions, posterior procedures, and non-MIS fusions. Mori et al. Conclusion Finally, factors such as general condition, comorbidities, and neurological conditions were not considered. The global lumbar spine value was defined as the average of the values obtained from L23 to L5S1. A comprehensive review of the available English literature, including relevant abstracts and references of articles selected for review, was . The clinical outcomes were based on the visual analog scale (VAS) score for pain and the Japanese Orthopaedic Association (JOA) score at 1week, 3months, and 2years after operation. Part 2: Histologic and histochemical analyses in humans. reported less edema and atrophy of the multifidus muscle in patients that received MIS as compared to those that received COS at 6months postoperatively13. Connecting them prevents movement between them. All statistical comparisons were 2-tailed, and the threshold for statistical significance was set at P<0.05. Analysis of the posterior ramus of the lumbar spinal nerve: the structure of the posterior ramus of the spinal nerve. Histograms of the sum of right and left paraspinal muscles on MRI and CT. Would you like email updates of new search results? The site is secure. The site is secure. The Effect of Paraspinal Muscle Degeneration on Distal Pedicle Screw Loosening Following Corrective Surgery for Degenerative Lumbar Scoliosis. To obtain doi: 10.1097/MD.0000000000032051. OLIF may not result in paraspinal muscle atrophy at 24months after surgery. -, Tsutsumimoto T, Shimogata M, Ohta H, Misawa H. Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis: comparison of paraspinal muscle damage and slip reduction. Regarding motion-preserving surgical treatment such as total disc replacement, a significantly lower ratio of adjacent-segment degeneration was reported compared with the fusion approach [38]. BackgroundDifferent studies have shown that atrophy ofparaspinal muscles arises after open dorsal lumbar fusion,and the reasons for this atrophy are still not yet fully clarified.This prospective study investigates the extent of atrophy of thelumbar paraspinal muscles after open lumbar interbody fu-sion, its possible causes, and their associatio. doi: 10.1097/BRS.0b013e3182022d32. Spine (Phila Pa 1976) 32, 12361241. WT and XJY participated in acquisition, analysis, or interpretation of data and draft the manuscript. Clipboard, Search History, and several other advanced features are temporarily unavailable. In the COS group, the paraspinal muscles were dissected away from the posterior elements (spinal process, lamina, and facet joints) via a midline approach, and laminotomy was performed at the index level with preservation of the adjacent supra- and inter-spinous ligament. It has been shown in the lumbar spine that preservation of the posterior ramus of the spinal nerve is important in minimizing paraspinal muscle atrophy. Article Clin. Hyun, S. J., Kim, Y. J. PMC Stevens et al. MML, JKW, WHW and YHX collect data. https://doi.org/10.1016/j.math.2012.06.007 (2012). Imaging of muscle and adipose tissue in the spine: A narrative review. It is clinically important to clarify and compare changes in paraspinal muscles after the various surgeries. We sought to identify changes in back muscle atrophy between the two groups, with analysis of the impact of these changes on clinical outcomes. Computed tomography (CT) was used to measure functional cross-sectional area (FCSA) and fat infiltration percentage (FIP) of the multifidus and erector spinae before and 24months after surgery. Saito T, Steinke H, Miyaki T, Nawa S, Umemoto K, Miyakawa K, et al. You are using a browser version with limited support for CSS. Bookshelf Denervation and atrophy of paraspinal muscles after open lumbar interbody fusion is associated with clinical outcome--electromyographic and CT-volumetric investigation of 30 patients. There are some limitations to this study. Epub 2023 Jan 20. Postoperative muscular fatty infiltration was more prominent (may be more detectable) at the lower lumbar level.

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