The Effect of Paraspinal Fatty Muscle Infiltration and Cumulative Lumbar Spine Degeneration on the Outcome of Patients with Lumbar Spinal Canal Stenosis: Analysis of the Lumbar Stenosis Outcome Study (LSOS) Data

Abstract

Study Design. Prospective. Objective. To investigate the influence of paraspinal fatty muscle infiltration (FMI) and cumulative lumbar spine degeneration as assessed by magnetic resonance imaging on long-term clinical outcome measures in patients with lumbar spinal canal stenosis (LSCS) of the Lumbar Stenosis Outcome Study (LSOS) cohort. Summary of Background Data. Past studies have tried to establish correlations of morphologic imaging findings in LSCS with clinical endpoints. However, the impact of FMI and overall lumbar spinal degeneration load has not been examined yet. Materials and Methods. Patients from the LSOS cohort with moderate to severe LSCS were included. Two radiologists assessed the degree of LSCS as well as cumulative degeneration of the lumbar spine. FMI was graded using the Goutallier scoring system. Spinal Stenosis Measure (SSM) was used to measure the severity level of symptoms and disability. European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) was used to measure health-related quality of life. Results. The nonsurgically treated group consisted of 116 patients (age 74.8±8.5 yr), whereas the surgically treated group included 300 patients (age 72.3±8.2 yr). Paraspinal FMI was significantly different between the groups (54.3% vs. 32.0% for Goutallier grade ≥2; P<0.001). Total degeneration score was comparable in both groups (9.5±2.0 vs. 9.3±2.0; P=0.418). FMI was associated with lower SSM function and lower EQ-5D-3L (all P<0.05), but not with SSM symptoms. Total degeneration of the lumbar spine was associated neither with SSM symptoms, nor with SSM function, nor with EQ-5D-3L (all P>0.05). Conclusions. FMI is associated with higher disability and worse health-related quality of life of LSCS patients in the LSOS cohort. There was no significant association between total cumulative lumbar spine degeneration and the outcome of either surgically or nonsurgically treated patients. Level of Evidence. 3.

Associations of Quantitative and Qualitative Muscle Parameters With Second Hip Fracture Risk in Older Women: A Prospective Cohort Study

“…The Goutallier classification serves as a widely used tool for evaluating fatty degeneration or infiltration of musculature, ( 20 , 21 ) particularly in conditions such as rotator cuff tears ( 22 , 23 ) and muscle atrophy. ( 24 , 25 ) Previous studies have shown the prognostic value of the Goutallier classification in clinical and radiologic outcome studies on the fatty infiltration of the rotator cuff musculature.…”

Can lumbar paraspinal muscle/fat ratio and spinopelvic parameters predict short-term outcomes after decompressive surgeries in lumbar disc herniation and lumbar spinal stenosis?

“…suggested that fatty infiltration of paraspinal muscles is associated with higher disability and poor health-related quality of life. [ 23 ] Zotti et al . demonstrated that less muscle mass of LM was correlated with worse outcome in patients who had decompression surgery for LSS.…”

The Difference in Paraspinal Muscle Parameters and the Correlation with Health-Related Quality of Life among Healthy Individuals, Patients with Degenerative Lumbar Scoliosis and Lumbar Spinal Stenosis

“…Miki et al [8] used the NRS, RMDQ, and EQ-5D scales and found that a decreased MF CSA was associated with lower back pain. Getzmann, J.M., et al [22] found that fatty muscle infiltration was associated with higher rates of disability and worse HRQOL in patients with EQ-5D-3L scores. Han et al [23] found a significant correlation among paraspinal muscle endurance, VAS scores, and ODI scores in patients with LSS.…”