Quantitative MRI comparability of multifidus muscle degeneration in thoracolumbar fractures handled with open and minimally invasive strategy.
BMC Musculoskelet Disord. 2018 03 07;19(1):75
Authors: Gilbert F, Heintel TM, Jakubietz MG, Köstler H, Sebald C, Meffert RH, Weng AM
BACKGROUND: Minimally invasive pedicle screw fixation has much less approach-related morbidity than open screw placement and is allegedly much less traumatizing on paravertebral muscle tissue, as there isn’t a requirement to mobilize and retract the adjoining muscle portion. The approach-related long-term results to the morphology of the paravertebral muscle tissue are unknown. The aim of this research was to match the long-term quantity of fatty degeneration of the multifidus muscle in sufferers handled with a classical open or a minimally invasive strategy.
METHODS: Fourteen Sufferers assembly inclusion standards have been chosen. In all sufferers a singular fracture of the thoracolumbar backbone with a two-level posterior instrumentation was handled, both utilizing an open strategy or a minimally invasive strategy. All sufferers underwent quantitative MRI spectroscopy for quantification of the fatty degeneration within the multifidus muscle as a long-term proof for muscle loss after minimal Four-year follow-up. Medical consequence was assessed utilizing Oswestry Low Again Ache Incapacity Questionnaire, SF-36 and VA-scale for ache.
RESULTS: The minimally invasive strategy group failed to point out much less muscle degeneration compared to the open group. Complete quantity of fatty degeneration was 14.22% within the MIS group and 12.60% within the open group (p?=?zero.64). In accordance to MRI quantitative outcomes there was no distinction within the scientific consequence after a imply comply with up of 5.9 years (±1.eight).
CONCLUSION: As short-term benefits of minimal invasive screw placement have been extensively demonstrated, no benefit of the MIS, displaying a major distinction within the quantity of fatty degeneration and leading to a greater scientific consequence could possibly be discovered. Moreover the well-known short-term benefit of minimally invasive pedicle screw placement, a long-term benefit, reminiscent of much less muscle degeneration and thus superior scientific outcomes, in comparison with the open strategy couldn’t be proven.
PMID: 29514622 [PubMed – indexed for MEDLINE]