Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion: 10-year follow-up study using MRI

Abstract

Purpose To evaluate changes in the transverse area of deep posterior muscles of the cervical spine 10 years after anterior cervical decompression and fusion (ACDF), in comparison with healthy volunteers. Methods Thirty-one patients (22 males, 9 females, mean age at follow-up 59.3 years, mean follow-up 12.1 years) who had undergone preoperative MRI and non-instrumented ACDF within levels C3-4 to C5-6 were enrolled. 32 asymptomatic volunteers (17 males, 15 females; mean age, 54.7 years; mean follow-up, 11.7 years) who underwent MRI between 1993 and 1996 served as controls. Follow-up MRI was performed on both patients and control subjects, and the cross-sectional areas of deep posterior muscles were measured digitally at levels C3-4, 4-5, and 5-6. Results The mean total cross-sectional area in the ACDF and control groups was 4,693.6 ± 1,140.9 and 4,825.8 ± 1,048.2 mm 2 in the first MR study (P = 0.63), and 4,616.7 ± 1,086.0 and 5,036.7 ± 1,105.6 mm 2 at followup (P = 0.13). The total cross-sectional area in the ACDF group slightly decreased, while that in the control group increased (-77.1 ± 889.7 vs. 210.9 ± 622.0 mm 2 , P = 0.14). The mean change in the cross-sectional area had no significant correlation with clinical symptoms, including neck pain or JOA score. Conclusions ACDF patients did not show a marked decrease in the cross-sectional area of the deep posterior cervical muscles, but as compared with control subjects there was a slight decrease. A decrease in the cross-sectional area of these muscles after ACDF may not result in the axial symptoms as seen in patients treated by posterior surgery.

Cervical muscle area measurements in whiplash patients: Acute, 3, and 6 months of follow‐up

“…In the present study, women had significant smaller muscle volumes than men for all measured muscles at all levels analogous to the findings of Matsumoto et al (11) and Okada et al (12). The fact that women suffer more often from whiplash injury (13) is well known.…”

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

“…According to our search, eleven studies were found, four of which were prospective and seven retrospective. Six studies were concentrated on anterior approaches (Table 1 [19][20][21][22][23]) and five studies on posterior approaches in the cervical spine (Table 2 [24][25][26][27][28][29]).…”

The Relationship between Increased Intervertebral Disc Height and Development of Postoperative Axial Neck Pain after Anterior Cervical Fusion

“…No significant association was observed between neck pain and changes in the cross-sectional area of the posterior muscles over time. Thus, they demonstrated the advantage of ACDF in preserving the posterior muscles, thereby making postoperative axial pain less likely13). In the case of cervical arthroplasty, 25% of patients also reported neck and shoulder pains during follow-up period14).…”

“…They concluded that more than half (57%) of the patients recovered well after surgery, with still many patients experiencing chronic neck pain and physical dysfunction with decreased neck movement and strength. Another study on neck pain after ACDF was conducted by Matsumoto et al 13) , who reported that neck pain was observed in 25.8% of the ACDF patients at the follow-up period. No significant association was observed between neck pain and changes in the cross-sectional area of the posterior muscles over time.…”