Comparison of CT Scan Muscle Measurements and Isokinetic Trunk Strength in Postoperative Patients

Mayer, Tom G.; Vanharanta, Heikki; Gatchel, Robert J.; Mooney, Vert; Barnes, Dennis; Judge, Linda; Smith, Sue; Terry, Arthur F.

doi:10.1097/00007632-198901000-00006

Cited by 287 publications

(147 citation statements)

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“…Again these changes were localized to the level of injury and were associated with rapid changes in intra-muscular fat. Several studies evaluated the association between CT-evaluated paraspinal muscles density and LBP [14,15,19,28,29,34,40]. Muscle density is an expression of degeneration of the muscles and reflects the number of muscle fibers, the area of the individual muscle fiber, and the packing of the contractile material [22], whereas the CSA is mainly determined by the total number of muscle fibers, to a lesser degree, the size of the fibers [35,36], and the quantity of fat in the muscle [6,9].…”

Section: Discussionmentioning

confidence: 99%

“…With increasing age, there is a reduction in muscle volume [13,35]. Current evidence suggests that the paraspinal muscles are smaller in patients with chronic LBP [4,6,40,50] than in healthy individuals of similar age. Reduced size of multifidus has also been reported in acute LBP [16] and recent animal work has shown rapid changes in CSA in the multifidus muscle following discrete injury to an intervertebral disc [17].…”

Section: Introductionmentioning

confidence: 99%

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Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

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The objectives of the study were to evaluate the association between lumbar paraspinal muscle density, evaluated on computed tomography (CT) and age, sex and BMI; and to evaluate the association of those changes with low back pain (LBP) and spinal degeneration features in a community-based sample. This study was an ancillary project to the Framingham Study. A sample of 3,529 participants aged 40-80 years had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this study. LBP in the last 12 months was evaluated using self-report questionnaire. Density (in Hounsfield units) of multifidus and erector spinae was evaluated on CT. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (FJOA), spondylolysis, spondylolisthesis and spinal stenosis were also evaluated. We used linear regression models to examine the association of paraspinal muscles density with age, sex, BMI, LBP, and spinal degeneration features. The results show that in our study, men have higher density of paraspinal muscles than women, younger individuals have higher density than older ones and individuals with lower weight have higher muscle density than overweight. No differences between individuals with and without LBP were found. Significant association was found between L4 multifidus/erector spinae density and FJOA at L4-L5; between multifidus at L4 and spondylolisthesis at L4-5; and between erector spinae at L4 and L5 with disc narrowing at L4-5 and L5-S1, respectively. We conclude that the paraspinal muscle density decreases with age, and increases BMI. It is associated with at some levels FJOA, spondylolisthesis and disc narrowing at the same level, but not associated with occurrence of LBP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

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“…Extensive paraspinal muscle detachment from the midline osseous structures can cause weakness secondary to muscle denervation [9,10]. In addition, removal of the midline structures (i.e.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis

et al. 2015

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Purpose To compare the effectiveness of techniques of posterior decompression that limit the extent of bony decompression or to avoid removal of posterior midline structures of the lumbar spine versus conventional facetpreserving laminectomy for the treatment of patients with degenerative lumbar stenosis. Methods A comprehensive electronic search of the Cochrane Central Register of Controlled Trials, MED-LINE, EMBASE, Web of Science, and the clinical trials registries ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform was conducted for relevant literature up to June 2014. Results A total of four high-quality RCTs and six lowquality RCTs met the search criteria of this review. These studies included a total of 733 participants. Three different techniques that avoid removal of posterior midline structures are compared to conventional laminectomy; unilateral laminotomy for bilateral decompression, bilateral laminotomy and split-spinous process laminotomy. Evidence of low or very low quality suggests that different techniques of posterior decompression and conventional laminectomy have similar effects on functional disability and leg pain. Only perceived recovery at final follow-up was better in patients that underwent bilateral laminotomy compared with conventional laminectomy. Unilateral laminotomy for bilateral decompression and bilateral laminotomy resulted in numerically fewer cases of iatrogenic instability, although in both cases, the incidence of instability was low. The difference in severity of postoperative low back pain following bilateral laminotomy and split-spinous process laminotomy was significantly less, but was too small to be clinically important. We found no evidence to show that the incidence of complications, length of the procedure, length of hospital stay and postoperative walking distance differed between techniques of posterior decompression. Conclusion The evidence provided by this systematic review for the effects of unilateral laminotomy for bilateral decompression, bilateral laminotomy and split-spinous process laminotomy compared with conventional laminectomy on functional disability, perceived recovery and leg pain is of low or very low quality. Therefore, further research is necessary to establish whether these techniques provide a safe and effective alternative for conventional laminectomy. Proposed advantages of these techniques regarding the incidence of iatrogenic instability and postoperative back pain are plausible, but definitive conclusions are limited by poor methodology and poor reporting of outcome measures among included studies.

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“…Structural changes in the spine and spinal muscles are inevitable and may be exacerbated by surgery [59,69]. By the time patients come to surgery, they are likely to have some degree of deconditioning syndrome [31,47]. The more severe and chronic the condition, the greater the need for post-operative rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

et al. 2006

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Post-operative management after lumbar surgery is inconsistent leading to uncertainty amongst surgeons and patients about post-operative restrictions, reactivation, and return to work. This study aimed to review the evidence on post-operative management, with a view to developing evidence-based messages for a patient booklet on post-operative management after lumbar discectomy or un-instrumented decompression. A systematic literature search produced a best-evidence synthesis of information and advice on post-operative restrictions, activation, rehabilitation, and expectations about outcomes. Evidence statements were extracted and developed into patient-centred messages for an educational booklet. The draft text was evaluated by peer and patient review. The literature review found little evidence for post-operative activity restrictions, and a strong case for an early active approach to postoperative management. The booklet was built around key messages derived from the literature review and aimed to reduce uncertainty, promote positive beliefs, encourage early reactivation, and provide practical advice on self-management. Feedback from the evaluations were favourable from both review groups, suggesting that this evidence-based approach to management is acceptable and it has clinical potential.

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Comparison of CT Scan Muscle Measurements and Isokinetic Trunk Strength in Postoperative Patients

Cited by 287 publications

References 0 publications

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

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