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Preoperative Fatty Infiltration Of Paraspinal Muscles Assessed By MRI Is Associated With Less Improvement Of Leg Pain 2 Years After Surgery For Lumbar Spinal Stenosis London Spine Lumbar Stenosis

The article examines the prognostic influence of fatty infiltration (FI) of the paraspinal muscles on pain and disability in patients undergoing surgery for lumbar spinal stenosis (LSS). A muscle fat index (MFI) was calculated based on preoperative MRI scans, and patients were assessed for pain and disability 2 years after surgery. The results showed a significant association between preoperative MFI and postoperative leg pain, but not with other outcome measures such as disability. This suggests that preoperative FI of the paraspinal muscles may have a predictive value for postoperative leg pain in patients with LSS

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Preoperative FI of the paraspinal muscles on MRI showed statistically significant association with postoperative NRS leg pain but not with ODI or ZCQ.

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Abstract Purpose: Fatty infiltration (FI) of the paraspinal muscles may associate with pain and surgical complications in patients with lumbar spinal stenosis (LSS). We evaluated the prognostic influence of MRI-assessed paraspinal muscles’ FI on pain or disability 2 years after surgery for LSS. Methods: A muscle fat index (MFI) was calculated (by dividing signal intensity,

Abstract

Purpose: Fatty infiltration (FI) of the paraspinal muscles may associate with pain and surgical complications in patients with lumbar spinal stenosis (LSS). We evaluated the prognostic influence of MRI-assessed paraspinal muscles’ FI on pain or disability 2 years after surgery for LSS.

Methods: A muscle fat index (MFI) was calculated (by dividing signal intensity of psoas to multifidus and erector spinae) on preoperative axial T2-weighted MRI of patients with LSS. Pain and disability 2 years after surgery were assessed using the Oswestry disability index, the Zurich claudication questionnaire and numeric rating scales for leg and back pain. Multivariate linear and logistic regression analyses (adjusted for preoperative outcome scores, age, body mass index, sex, smoking status, grade of spinal stenosis, disc degeneration and facet joint osteoarthritis) were used to assess the associations between MFI and patient-reported clinical outcomes. In the logistic regression models, odds ratios (OR) and 95% confidence intervals (CI) were calculated for associations between the MFI and ≥ 30% improvement of the outcomes (dichotomised into yes/no).

Results: A total of 243 patients were evaluated (mean age 66.6 ± 8.5 years), 49% females (119). Preoperative MFI and postoperative leg pain were significantly associated, both with leg pain as continuous (coefficient – 3.20, 95% CI – 5.61, – 0.80) and dichotomised (OR 1.51, 95% CI 1.17, 1.95) scores. Associations between the MFI and the other outcome measures were not statistically significant.

Preoperative FI of the paraspinal muscles on MRI showed statistically significant association with postoperative NRS leg pain but not with ODI or ZCQ.

Keywords: Magnetic Resonance Imaging; Outcome measure; Paraspinal muscles; Regression; Spinal stenosis.

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Preoperative fatty infiltration of paraspinal muscles assessed by MRI is associated with less improvement of leg pain 2 years after surgery for lumbar spinal stenosis

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Abstract Purpose: Fatty infiltration (FI) of the paraspinal muscles may associate with pain and surgical complications in patients with lumbar spinal stenosis (LSS). We evaluated the prognostic influence of MRI-assessed paraspinal muscles' FI on pain or disability 2 years after surgery for LSS. Methods: A muscle fat index (MFI) was calculated (by dividing signal intensity

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