Evaluation of Paraspinal Muscle Atrophy Proportion after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Utilizing a Novel Contralateral Intact Muscle-Managed Mannequin.
Asian Backbone J. 2018 Apr;12(2):256-262
Authors: Ortega-Porcayo LA, Leal-López A, Soriano-López ME, Gutiérrez-Partida CF, Ramírez-Barrios LR, Soriano-Solis S, Rodríguez-García M, Soriano-Solis HA, Soriano-Sánchez JA
Research Design: Retrospective comparative scientific research.
Objective: This research aimed to evaluate paraspinal muscle atrophy in sufferers who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation utilizing a novel contralateral intact muscle-controlled mannequin.
Overview of Literature: The elevated incidence of paravertebral lumbar muscle accidents after open strategies has raised the significance of implementing minimally invasive backbone surgical strategies utilizing tubular retractors and minimally invasive screw placement. The practical cross-sectional space (FCSA) represents the lean muscle mass; moreover, FCSA is a helpful marker of the contractile skill of a muscle following a backbone surgical procedure. Nevertheless, the advantages of unilateral fixation and MI-TLIF on paraspinal muscle tissues haven’t been outlined.
Strategies: We carried out a retrospective imagenological evaluate on eleven sufferers who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae have been measured 1 yr after surgical procedure at adjoining ranges and have been in comparison with the contralateral intact muscle tissues. Measurement variations between the surgical and nonsurgical websites have been in contrast. The interobserver reliability was calculated utilizing an intraclass correlation coefficient.
Outcomes: The imply FCSA on the surgical web site was 20.97±5.07 cm2 on the superior stage and eight.89±2.87 cm2 on the inferior stage. The imply FCSA on the contralateral nonsurgical web site was 20.15±5.95 cm2 on the superior stage and 9.20±2.66 cm2 on the inferior stage was. The superior and inferior FCSA measurements confirmed no important distinction between the surgical and nonsurgical websites (p=zero.5, p=zero.922, respectively).
Conclusions: Utilizing a mini-open tubular method via the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle harm on the superior and inferior adjoining ranges.
PMID: 29713406 [PubMed]