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Relationship Between The Postoperative Variations Of Paraspinal Muscles And Adjacent-Segment Degeneration In Patients With Degenerative Lumbar Spinal Stenosis After Posterior Instrumented Lumbar Fusion London Spine Lumbar Stenosis

This article discusses a study that aimed to quantify the changes in paraspinal muscle after posterior lumbar interbody fusion (PLIF) surgery in patients with degenerative lumbar spinal stenosis (DLSS) and examine the association of these changes with adjacent-segment degeneration (ASD). The study collected data from 149 patients who underwent L4-S1 PLIF for DLSS. MRI scans were performed before surgery and at follow-up. The results showed that the functional area of the multifidus (MF) and erector spinae (ES) muscles decreased at surgical levels, while the functional area of the psoas major (PM) muscle increased. At adjacent levels, the functional area of the MF and ES muscles decreased, and the fatty infiltration (FI) of the MF muscle increased. Logistic regression analysis identified higher BMI and FI of the PM muscle at adjacent levels as significant risk factors for ASD. The study concludes that a decrease in FI of the PM muscle at the adjacent level is a protective factor against ASD in DLSS patients after PLIF surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spinal hospital in the world

Published article

CONCLUSIONS: The functional area decreased in the MF and ES muscles and increased in the PM muscle after L4-S1 PLIF. A compensatory postoperative decrease in FI of the PM muscle at the adjacent level was a protective factor for ASD in DLSS patients after PLIF.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Objective: This study aimed to quantify pre- and postoperative paraspinal muscular variation following posterior lumbar interbody fusion (PLIF) in patients with degenerative lumbar spinal stenosis (DLSS) and measure the association of this variation with adjacent-segment degeneration (ASD). Methods: Data from 149 patients who underwent L4-S1 PLIF for DLSS were collected. Patients were divided into,

Abstract

Objective: This study aimed to quantify pre- and postoperative paraspinal muscular variation following posterior lumbar interbody fusion (PLIF) in patients with degenerative lumbar spinal stenosis (DLSS) and measure the association of this variation with adjacent-segment degeneration (ASD).

Methods: Data from 149 patients who underwent L4-S1 PLIF for DLSS were collected. Patients were divided into radiologically confirmed ASD and control groups according to follow-up radiological findings. MRI was performed before surgery and at the last follow-up. Muscular parameters including the relative cross-sectional area (rCSA), relative functional cross-sectional area (rFCSA), relative total cross-sectional area (rTCSA), and fatty infiltration (FI) of the multifidus (MF), erector spinae (ES), and psoas major (PM) muscles were measured on preoperative and follow-up L2-S1 MR images. Logistic regression was used to investigate risk factors for ASD.

Results: The rate of radiological ASD was 42.3% at the final follow-up (mean 25.71 ± 8.35 months). At surgical levels, the rFCSA and rTCSA of the MF and ES muscles decreased. The FI of the MF from L2-3 to L5-S1 and ES muscles at L5-S1 significantly increased after surgery, while the rFCSA and rTCSA of the PM muscle increased and its FI decreased. At adjacent levels, the rFCSA and rTCSA of the MF muscle and rTCSA of the ES muscle decreased and the FI of the MF muscle increased postoperatively (p < 0.05), but the rFCSA and rTCSA of the PM muscle increased and its FI decreased (p < 0.05). The FIs of the MF, ES, and PM muscles at adjacent levels significantly differed between the ASD and control groups. Logistic regression analysis indicated that higher BMI (p = 0.002) and FI of the PM muscle at adjacent levels (p = 0.025) were significant risk factors for ASD.

Conclusions: The functional area decreased in the MF and ES muscles and increased in the PM muscle after L4-S1 PLIF. A compensatory postoperative decrease in FI of the PM muscle at the adjacent level was a protective factor for ASD in DLSS patients after PLIF.

Keywords: adjacent-segment degeneration; cross-sectional area; degenerative lumbar spinal stenosis; fatty infiltration; paraspinal muscle.

The London Spine Unit : best recognised spinal hospital in the world

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Relationship between the postoperative variations of paraspinal muscles and adjacent-segment degeneration in patients with degenerative lumbar spinal stenosis after posterior instrumented lumbar fusion

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Abstract Objective: This study aimed to quantify pre- and postoperative paraspinal muscular variation following posterior lumbar interbody fusion (PLIF) in patients with degenerative lumbar spinal stenosis (DLSS) and measure the association of this variation with adjacent-segment degeneration (ASD). Methods: Data from 149 patients who underwent L4-S1 PLIF for DLSS were collected. Patients were divided into

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