Transcutaneous neuromuscular electrical stimulation applied to optimal points on the lower abdomen and lumbar paraspinal region changes gait parameters in patients with lumbar degenerative kyphosis

Jung, Gil Su; Lee, Hee Jin; Seo, Sang Wan; Lee, Dong Gyu; Kwak, Sang Gyu; Cho, Hee Kyung; Ahn, Sang Ho

doi:10.3233/bmr-169638

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…2 ); however, the FIA of both ES and MF are comparable between the two groups. The results demonstrate the key role of lumbar extensor muscle atrophy in the compensatory mechanism [ 11 , 22 ]. ES might play a more crucial role than MF because ES muscularity, other than MF, correlated with sagittal global balance parameters consisting of SVA, PI–LL, and TPA and spinal alignment including LL and DLL.…”

Section: Discussionmentioning

confidence: 95%

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Erector Spinae Atrophy Correlates with Global Sagittal Imbalance and Postoperative Proximal Junctional Kyphosis Incidence in Lumbar Degenerative Kyphosis

Wang,

Li,

Zhang

et al. 2024

Asian Spine J

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Study Design: Retrospective cohort study.Purpose: This study aimed to investigate the relationship between lumbar erector muscle atrophy and global sagittal imbalance in lumbar degenerative kyphosis (LDK) and with postoperative proximal junctional kyphosis.Overview of Literature: Lumbar erector muscle atrophy has been studied in LDK. However, its role in the compensatory mechanism is still under intense discussion, and the role of erector spinae (ES) muscle is always overlooked.Methods: This study enrolled 51 patients with LDK out of 382 patients with adult degenerative spinal deformity. Baseline information was reviewed including demographic data and complications. Sagittal spinopelvic alignments and global imbalance parameters were assessed on full-length X-ray images of the spine. Muscularity and the fatty infiltration area of the ES and multifidus (MF) were measured at the L4/5 level on preoperative magnetic resonance image to evaluate the lumbar erector muscle atrophy. Stratification by sagittal vertical axis (SVA) was performed: group 1 with SVA <100 mm and group 2 with SVA >100 mm, and these groups were compared. Spearman correlation and multivariable logistic regression analyses were performed to analyze and define risk factors of postoperative proximal junctional kyphosis (PJK).Results: Group 2 had lower ES and MF muscularity than group 1. ES muscularity correlated with SVA (r=−0.510, p<0.003), lumbar lordosis (r=−0.415, p<0.018), and postoperative PJK (r=−0.508, p<0.022). MF muscularity did not correlate with the above parameters. Multivariable logistic regression analysis verified ES muscularity (odds ratio [OR], 0.001; p<0.039) and SVA (OR, 1.034; p<0.048) as the risk factors for postoperative PJK.Conclusions: ES atrophy, besides the MF, is an important predictor in distinguishing decompensated LDK from well-compensated ones. It plays an important role in compensatory mechanism, not only correlates with global sagittal imbalance but also ties to PJK after deformity corrective surgery.

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Section: Discussionmentioning

confidence: 95%

“…A flat or lordotic thoracolumbar junction is the predictor of well compensation [5]. Lumbar extensor muscles, particularly the ES, might be crucial in the compensatory mechanism [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Erector Spinae Atrophy Correlates with Global Sagittal Imbalance and Postoperative Proximal Junctional Kyphosis Incidence in Lumbar Degenerative Kyphosis

Wang,

Li,

Zhang

et al. 2024

Asian Spine J

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“…Of course, as LSS from complex pathophysiological changes, there are many factors that can decrease the volume of the spinal canal, such as lumbar kyphosis [30,31], loss of physiological lordosis [32], giant central lumbar disc herniation [33,34], and lateral recess stenosis [35], and can result in typical clinical symptoms of LSS. Not all LSS cases will show a positive Sedsign, which suggests that there are limitations of Sedsign determination in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Relative risk factors of nerve root sedimentation sign (Sedsign) in patients with severe central lumbar spinal stenosis (LSS)

Yan

et al. 2021

Preprint

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Here we evaluated the incidence of positive nerve root sedimentation sign (Sedsign) and its correlation with MRI parameters in patients with severe lumbar spinal stenosis (LSS) to explore its pathogenesis. Among 209 patients with severe LSS, there were 290 levels with intervertebral narrowing, among which 248 had a positive Sedsign (a prevalence of 85.52%). We then analyzed those levels with a positive Sedsign relative to those with a negative Sedsign (42 levels). There was no significant difference between the two groups for the minimum cross-sectional area (CSA) of the dural sac or the minimum posteroanterior diameter (PAD) of the spinal canal. In contrast, there was a significant difference between the groups for the grade of degenerative facet joint (DFJ) (p < 0.05), the maximum thickness of ligamentum flavum (TLF) (p < 0.01), and the maximum cross-sectional area difference (CSAD) of the dural sac (p < 0.01). In addition, receiver operating characteristic (ROC) curves were used to identify associated factors. The area under the ROC curve for PAD was 0.608 (95%CI: 0.55−0.665, p < 0.05), for DFJ was 0.634 (95%CI: 0.576−0.69, p < 0.05), for TLF was 0.74 (95%CI: 0.742−0.839, p < 0.01), and for CSAD was 0.911 (95%CI: 0.875−0.943, p < 0.01). In summary, a positive Sedsign has notable advantages in assisting with the diagnosis of severe LSS. Compression of the dural sac from the rear may be the main cause of a positive Sedsign, and the TLF and DFJ parameters were the main relative risk factors.

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Relative risk factors of nerve root sedimentation sign (SedSign) in patients with severe central lumbar spinal stenosis (LSS)

Han

Zhang

et al. 2023

All Life

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Transcutaneous neuromuscular electrical stimulation applied to optimal points on the lower abdomen and lumbar paraspinal region changes gait parameters in patients with lumbar degenerative kyphosis

Abstract: Transcutaneous NMES applied at optimal points on the lower abdomen and back could provide a means of treating gait problems caused by a stooped trunk in LDK patients.

Cited by 3 publications

References 20 publications

Erector Spinae Atrophy Correlates with Global Sagittal Imbalance and Postoperative Proximal Junctional Kyphosis Incidence in Lumbar Degenerative Kyphosis

Erector Spinae Atrophy Correlates with Global Sagittal Imbalance and Postoperative Proximal Junctional Kyphosis Incidence in Lumbar Degenerative Kyphosis

Relative risk factors of nerve root sedimentation sign (Sedsign) in patients with severe central lumbar spinal stenosis (LSS)

Relative risk factors of nerve root sedimentation sign (SedSign) in patients with severe central lumbar spinal stenosis (LSS)

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