19 Harley St, London, W1G 9QJ, UK

Relationship between lumbar spinal stenosis and axial muscle wasting – Lumbar Fusion

Day Case Lumbar Fusion Surgery

This article presents the findings of a retrospective cross-sectional study that aimed to assess the association between lumbar spinal stenosis (LSS) and atrophy of the posterior paraspinal musculature (PPM). The study analyzed lumbar MRI scans of patients with low back pain or undergoing preoperative evaluation at a tertiary orthopedic center. The results showed a significant increase in fatty infiltration (FI) of the PPM with LSS at any lumbar level, although there was no significant decrease in the functional cross-sectional area (fCSA). The severity of LSS at L4/5 was positively associated with the fCSA. The study suggests that patients with LSS may be susceptible to axial muscle wasting, which could worsen LSS and lead to a positive feedback loop

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised sugical centre in London

Published article

S: In this study, we demonstrated a significant and independent association between LSS and the composition of the PPM, which was dependent on the level of LSS relative to the PPM. In addition to neurogenic claudication, patients with LSS might be especially susceptible to axial muscle wasting, which could worsen LSS due to increased spinal instability, leading to a positive feedback loop.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine J. 2023 Oct 1:S1529-9430(23)03428-9. doi: 10.1016/j.spinee.2023.09.020. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Although the effect of lumbar spinal stenosis (LSS) on the lower extremities is well documented, limited research exists on the effect of spinal stenosis on the posterior paraspinal musculature (PPM). Similar to neurogenic claudication, moderate to severe spinal canal compression can also interfere,

Spine J. 2023 Oct 1:S1529-9430(23)03428-9. doi: 10.1016/j.spinee.2023.09.020. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Although the effect of lumbar spinal stenosis (LSS) on the lower extremities is well documented, limited research exists on the effect of spinal stenosis on the posterior paraspinal musculature (PPM). Similar to neurogenic claudication, moderate to severe spinal canal compression can also interfere with the innervation of the PPM, which may result in atrophy and increased fatty infiltration (FI).

PURPOSE: This study aims to assess the association between LSS and atrophy of the PPM.

STUDY DESIGN: Retrospective cross-sectional study.

PATIENT SAMPLE: Patients undergoing MRI scans at a tertiary orthopedic center for low back pain or as part of a preoperative evaluation.

OUTCOME MEASURES: The functional cross-sectional area (fCSA) and percent fatty infiltration (FI) of the PPM at L4.

METHODS: Lumbar MRIs of patients at a tertiary orthopedic center indicated due to lower back pain (LBP) or as a presurgical workup were analyzed. Patients with previous spinal fusion surgery or scoliosis were excluded. LSS was assessed according to the Schizas classification at all lumbar levels. The cross-sectional area of the PPM was measured on a T2-weighted MRI sequence at the upper endplate of L4. The fCSA and fatty infiltration (FI) were calculated using custom software. Crude differences in FI and fCSA between patients with no stenosis and at least mild stenosis were tested with the Wilcoxon signed-rank test. To account for possible confounders, a multivariable linear regression model was used to adjust for age, sex, body mass index (BMI), and disc degeneration. A subgroup analysis according to MRI indication was performed.

RESULTS: A total of 522 (55.7% female) patients were included. The median age was 61 years (IQR: 51 – 71). The greatest degree of moderate and severe stenosis was found at L4/5, 15.7%, and 9.2%, respectively. Stenosis was the least severe at L5/S1 and was found to be 2% for moderate and 0.2% for severe stenosis. The Wilcoxon test showed significantly increased FI of the PPM with stenosis at any lumbar level (p < 0.001), although no significant decrease in fCSA was observed. The multivariable regression model showed a significant increase in FI with increased LSS at L1/2, L2/3, and L3/4 (p = 0.013, p <0.01 and p =0.003). The severity of LSS at L4/5 showed a positive association with the fCSA (p = 0.019). The subgroup analysis showed, the effect of LSS was more pronounced in non-surgical patients than in patients undergoing surgery.

S: In this study, we demonstrated a significant and independent association between LSS and the composition of the PPM, which was dependent on the level of LSS relative to the PPM. In addition to neurogenic claudication, patients with LSS might be especially susceptible to axial muscle wasting, which could worsen LSS due to increased spinal instability, leading to a positive feedback loop.

PMID:37788745 | DOI:10.1016/j.spinee.2023.09.020

The London Spine Unit : most specialised sugical centre in London

Read the original publication:

Relationship between lumbar spinal stenosis and axial muscle wasting

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Spine J. 2023 Oct 1:S1529-9430(23)03428-9. doi: 10.1016/j.spinee.2023.09.020. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Although the effect of lumbar spinal stenosis (LSS) on the lower extremities is well documented, limited research exists on the effect of spinal stenosis on the posterior paraspinal musculature (PPM). Similar to neurogenic claudication, moderate to severe spinal canal compression can also interfere

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810