Sarcopenia, Ectopic Fat Infiltration Into the Lumbar Paravertebral Muscles, and Lumbo-Pelvic Deformity in Older Adults Undergoing Lumbar Surgery

Lee, Dong Hoon; Kuroki, Tomofumi; Nagai, Takuya; Kawano, Kimiko; Higa, Kiyoshi; Kurogi, Syuji; Hamanaka, Hideaki; Chosa, Etsuo

doi:10.1097/brs.0000000000004175

Cited by 12 publications

(9 citation statements)

References 44 publications

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“…In the elderly, paravertebral adipose tissue accumulates again due to ectopic fat infiltration into the lumbar paravertebral muscles. Its accumulation can also be observed in some pathological conditions with paravertebral muscle atrophy and degeneration [ 12 , 13 ]. In paediatric neurosurgery, treatment of tethered cord syndrome requires exposure of the spinal laminae before entering the spinal canal, opening the dura, and transecting the filum terminale that connects the spinal cord to the sacral bone [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem Cells Isolated from Paediatric Paravertebral Adipose Tissue Show Strong Osteogenic Potential

et al. 2022

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Mesenchymal stem cells (MSCs) represent the basis of novel clinical concepts in cellular therapy and tissue regeneration. Therefore, the isolation of MSCs from various tissues has become an important endeavour for stem cell biobanking and the development of regenerative therapies. Paravertebral adipose tissue is readily exposed during spinal procedures in children and could be a viable source of stem cells for therapeutic applications. Here, we describe the first case of MSCs isolated from paravertebral adipose tissue (PV-ADMSCs), obtained during a routine spinal surgery on a child. Using quantitative real-time PCR and flow cytometry, we show that PV-ADMSCs have different levels of stem marker expression compared to the MSCs from other sources while having the highest proliferation rate. Furthermore, we evaluate the multipotency of PV-ADMSCs by the three-lineage (adipogenic, osteogenic and chondrogenic) differentiation and compare it to the multipotency of MSCs from other sources. It was found that the PV-ADMSCs have a strong osteogenic potential in particular. Taken together, our data indicate that PV-ADMSCs meet the criteria for successful cell therapy, defined by the International Society for Cellular Therapy (ISCT), and thus, could provide a source of MSCs that is relatively easy to isolate and expand in culture. Due to their strong osteogenic potential, these cells provide a promising basis, especially for orthopaedic applications.

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Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem Cells Isolated from Paediatric Paravertebral Adipose Tissue Show Strong Osteogenic Potential

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…Additionally, the severe FI group had a trend toward lower CL pre-and postoperatively. Evidence from the lumbar spine has also established the link between lumbar lordosis and FI (4,32). A biomechanical study by Patwardhan et al (33) investigated kinematic, kinetic, and muscular responses to cervical sagittal imbalance, presenting increased SVA to be associated with shortening of the cervical flexor and lengthening of the cervical extensor.…”

Section: Fsua Of Fusion Level (°)mentioning

confidence: 99%

The fatty infiltration into cervical paraspinal muscle as a predictor of postoperative outcomes: A controlled study based on hybrid surgery

Wu²,

Ding³

et al. 2023

Front. Endocrinol.

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BackgroundThe cervical paraspinal muscle (CPM) has an essential role in positioning, stabilizing and directing the cervical spine. However, information is lacking regarding the influence of CPM on outcomes following anterior cervical surgery. This study aims to evaluate the association of fatty infiltration (FI) of CPM with postoperative outcomes in patients undergoing hybrid surgery (HS) and analyze the relationship between FI and cross-sectional area (CSA) of CPM.MethodsA retrospective analysis was performed on 110 consecutive patients undergoing continuous 2-level HS. According to Goutallier classification of multifidus FI, the patients were divided into normal, moderate, and severe groups. Image J software was employed to outline and analyze CPM. Clinical outcomes and radiographic parameters were collected and evaluated for relevant comparisons.ResultsVisible FI was identified in 69.1% of patients (76/110), with a propensity in elderly patients (p = 0.053). No statistically significant differences were presented among the three groups regarding pre- and postoperative clinical evaluation scores. The cervical lordosis was significantly higher in the normal group before surgery (p = 0.029). Likewise, the sagittal vertical axis (SVA) was significantly higher in the severe group than the normal group at the final follow-up (p = 0.046). The function spine unit angle and disc angle of arthroplasty levels were significantly lower in the severe group than the normal group at follow-ups. Moreover, after correction according to vertebral body area, no statistically significant relationship existed between CSA ratio and FI grade.ConclusionCPM degeneration is common and age-related in patients with cervical disc degenerative disease. More importantly, there was a significant positive correlation between severe FI of CPM and postoperative sagittal balance disorder, particularly in C2-7 SVA and segmental alignment of arthroplasty level. Meanwhile, FI of CPM appears to have no impact on clinical outcomes and reveals small correlations to CSA.

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“…Why was pelvis flexion ROM also involved in the present regression model? Again, only LuM MFI (not fibrosis) would explain the positive relationship with ECHO LuM , as an increased MFI in the posterior vertebral muscles (erector spinae + LuM) has been associated with pelvic retroversion (Elysee et al, 2021; Lee et al, 2022; Zhang et al, 2021). However, MFI in LuM was not enough to induce a change in pelvic inclination in 93 healthy controls (Menezes‐Reis et al, 2018), which was later confirmed in a study showing a relationship with the erector spinae MFI but not LuM MFI in participants with spinal deformity (Miura et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

The relationship between clinical examination measures and ultrasound measures of fascia thickness surrounding trunk muscles or lumbar multifidus fatty infiltrations: An exploratory study

et al. 2022

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Patients with chronic low back pain (CLBP) exhibit remodelling of the lumbar soft tissues such as muscle fatty infiltrations (MFI) and fibrosis of the lumbar multifidus (LuM) muscles, thickness changes of the thoracolumbar fascia (TLF) and perimuscular connective tissues (PMCT) surrounding the abdominal lateral wall muscles. Rehabilitative ultrasound imaging (RUSI) parameters such as thickness and echogenicity are sensitive to this remodelling. This experimental laboratory study aimed to explore whether these RUSI parameters (LuM echogenicity and fascia thicknesses), hereafter called dependent variables (DV) were linked to independent variables (IV) such as (1) other RUSI parameters (trunk muscle thickness and activation) and (2) physical and psychological measures. RUSI measures, as well as a clinical examination comprising physical tests and psychological questionnaires, were collected from 70 participants with LBP. The following RUSI dependent variables (RUSI‐DV), measures of passive tissues were performed bilaterally: (1) LuM echogenicity (MFI/fibrosis) at three vertebral levels (L3/L4, L4/L5 and L5/S1); (2) TLF posterior layer thickness, and (3) PMCT thickness of the fasciae between subcutaneous tissue thickness (STT) and external oblique (PMCTSTT/EO), between external and internal oblique (PMCTEO/IO), between IO and transversus abdominis (PMCTIO/TrA) and between TrA and intra‐abdominal content (PMCTTrA/IA). RUSI measures of trunk muscle's function (thickness and activation), also called measures of active muscle tissues, were considered as independent variables (RUSI‐IV), along with physical tests related to lumbar stability (n = 6), motor control deficits (n = 7), trunk muscle endurance (n = 4), physical performance (n = 4), lumbar posture (n = 2), and range of motion (ROM) tests (n = 6). Psychosocial measures included pain catastrophizing, fear‐avoidance beliefs, psychological distress, illness perceptions and concepts related to adherence to a home‐based exercise programme (physical activity level, self‐efficacy, social support, outcome expectations). Six multivariate regression models (forward stepwise selection) were generated, using RUSI‐DV measures as dependent variables and RUSI‐IV/physical/psychosocial measures as independent variables (predictors). The six multivariate models included three to five predictors, explaining 63% of total LuM echogenicity variance, between 41% and 46% of trunk superficial fasciae variance (TLF, PMCTSTT/EO) and between 28% and 37% of deeper abdominal wall fasciae variance (PMCTEO/IO, PMCTIO/TrA and PMCTTrA/IA). These variables were from RUSI‐IV (LuM thickness at rest, activation of IO and TrA), body composition (percent fat) and clinical physical examination (lumbar and pelvis flexion ROM, aberrant movements, passive and active straight‐leg raise, loaded‐reach test) from the biological domain, as well as from the lifestyle (physical activity level during sports), psychological (psychological distress—cognitive subscale, fear‐avoidance beliefs during physical ac...

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Sarcopenia, Ectopic Fat Infiltration Into the Lumbar Paravertebral Muscles, and Lumbo-Pelvic Deformity in Older Adults Undergoing Lumbar Surgery

Cited by 12 publications

References 44 publications

Mesenchymal Stem Cells Isolated from Paediatric Paravertebral Adipose Tissue Show Strong Osteogenic Potential

Mesenchymal Stem Cells Isolated from Paediatric Paravertebral Adipose Tissue Show Strong Osteogenic Potential

The fatty infiltration into cervical paraspinal muscle as a predictor of postoperative outcomes: A controlled study based on hybrid surgery

The relationship between clinical examination measures and ultrasound measures of fascia thickness surrounding trunk muscles or lumbar multifidus fatty infiltrations: An exploratory study

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