The recovery of damaged paraspinal muscles by posterior surgical treatment for patients with lumbar degenerative diseases and its clinical consequence

Cha, Jae-Ryong; Kim, Yongchan; Yoon, Wan-Keun; Lee, Won-Gyu; Kim, Tae‐Hwan; Oh, Jae-Keun; Kim, Seok Woo; Ohn, Suk Hoon; Cui, Juncheng

doi:10.3233/bmr-150455

Cited by 5 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cha et al noted denervated erector spinae muscles at 12 months following pedicle screw fixation with fusion. 36 This is closely related to postoperative long-term low back pain and in stabilization. Problems found in another study included nerve root or vascular injury due to instrumentation-related complications.…”

Section: Discussionmentioning

confidence: 99%

Microscopic Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis

et al. 2022

View full text Add to dashboard Cite

Background: This is a study based on single-surgeon data on spinal stenosis surgery via microscopic approach. The aim is to evaluate the effectiveness of the unilateral approach to bilateral decompression and the usage of Taylor retractors and brain spatula in patients with spinal stenosis. Methods: This is a retrospective study on bilateral decompression for lumbar spinal stenosis using a microscopic unilateral approach by a single surgeon, between April 2015 and March 2018. In total, 50 patients were operated due to single level lumbar spinal stenosis. All patients were evaluated by preoperative and postoperative plain radiographs and magnetic resonance (MR) images. Walking distance (WD), visual analog scale (VAS) for pain and Odom’s criteria were evaluated for follow-up. Results: One level of the lumbar spine was surgically decompressed in all patients. The median age of patients was 64.6 (51– 82). Of the patients, 72% (36) were women, and 28% (14) were men. Most patients had refractory low back pain (96%) after conservative treatment. The stenotic levels of the cases were as follows: L3–4, 23(46%); L4–5, 24(48%); and L5–S1, 3 (6%). VAS scores decreased in all patients after surgery. According to Odom’s criteria, an excellent or good score was found in 43 patients at the 12th follow-up examination. WDs increased up to 1000 meters for 41 patients. Conclusion: The microscopic unilateral approach to bilateral decompression is an effective method for decompression in spinal stenosis. Via this approach, surgical trauma is reduced and surgically induced instability is avoided as much as possible.

show abstract

Section: Discussionmentioning

confidence: 99%

Microscopic Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The lumbar paraspinous muscle is of particular importance for the maintenance of stability and normal movement of spine [ 5 , 14 ]. Long incisions, extensive detachment of paraspinal muscles from the spinal processes, screws implant through multifidus muscle, and subsequently prolonged wide retraction can cause varying degrees of damage to paraspinous muscle, resulting in ischemic necrosis and denervation of the musculature in posterior lumbar surgery [ 7 , 12 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Lyophilized bovine acellular tendon linear fiber material for the reconstruction of attachment structure of paraspinous muscles: an animal in vivo study

Yuan

Tang

et al. 2022

J Mater Sci: Mater Med

View full text Add to dashboard Cite

Low back pain is common after lumbar spine surgery and the injury from extensive detachment of paraspinal muscles during the surgery may play a vital role. Previously, we prepared a bovine acellular tendon fiber (ATF) material through lyophilization and proved that it could retain its original fibrillar structure and mechanical properties. The objective of this study is to evaluate the effectiveness of this new fiber material used for attachment structure reconstruction of paraspinal muscle. Defect of spinous process, interspinous and supraspinous ligament was established on lumbar spine in rabbit and rat and ATF linear material was implanted to reconstruct the attachment structure. Ultrasound showed the cross-sectional area of the paraspinal muscle in ATF group was larger than that of control group in rats. MRI showed the irregular shape and high signal changes in control group, but regular shape and uniform signal in the ATF group in rabbit. For Electromyogram, the frequency of evoked potential in control group was lower than ATF group and normal rats. HE and Masson staining showed good tissue healing, and immunohistochemical results showed the immune rejection of ATF is significantly lower than that of suture. Reconstruction of the attachment structure of paraspinous muscles with ATF linear material could maintain the morphology, volume and function of paraspinal muscle. ATF material has the potential to be used to manufacture personalized ligaments and other tissue engineering scaffolds.

show abstract

“…As weight bearing begins and neurological improvement occurs, the observed changes may begin to revert to normal levels in response to the restoration of the normal biomechanics and anatomical alignment of the vertebral column. Many previous studies have highlighted the need for early rehabilitation and weight bearing (if possible) after the initial management of vertebral column injuries [11,12]. The limited strength observed in patients with SCI may be due to neurological factors or the insufficient muscle mass (more accurately, insufficient physiological muscle CSA) of neurally intact muscles.…”

Section: Discussionmentioning

confidence: 99%

“…By one way analysis of variance test. disease [12]. Postoperative computed tomography (CT) and MRI imaging studies have shown that reductions in the CSA of the spinal muscles occur, as well as changes in muscular density.…”

mentioning

confidence: 99%

Magnetic Resonance Imaging of Trunk Musculature and Intervertebral Discs in Patients with Spinal Cord Injury with Thoracolumbar Vertebral Fractures: A Prospective Study

et al. 2020

View full text Add to dashboard Cite

This study is a prospective clinical study. Purpose: This study aims to evaluate the characteristics of trunk musculature and intervertebral discs by using magnetic resonance imaging in patients with spinal cord injuries (SCIs) with thoracic and lumbar fractures. Overview of Literature: Muscle atrophy is an immediate consequence of SCI and is associated with secondary complications. At present, there are limited clinical data on muscle and disc responses to fractures of the thoracic and lumbar spine. Methods: A total of 51 patients with a mean age of 31.75±10.42 years who suffered traumatic SCI were included in this study. Complete neurological examinations (American Spinal Injury Association grading) and magnetic resonance imaging (MRI) were performed at the time of admission and at 3-6 months after injury to study the neurological status and disc and trunk parameters. The type of management (operative or conservative) was decided on the basis of clinical, radiological, and MRI evaluations, and a robust rehabilitation program was initiated. Results: Disc parameters including disc angle, skin angle, cross-sectional area (CSA), and disc height and trunk parameters (mean trunk width, mean trunk depth, and CSA of the lumbar muscles) decreased significantly (p<0.001) during the first 3 months after SCI. However, improvements were observed in disc and muscle parameters at the 6-month follow-up, but these parameters did not return to normal levels. Neither initial neurological status (complete vs. incomplete) nor type of management (operative vs. conservative) had a significant effect on these parameters. Conclusions: Spinal trauma leads to alterations in the morphology of the vertebral column, spinal cord, intervertebral discs, and paraspinal muscles in the initial phase of injury. The extent of these changes may determine the initial neurological deficit and subsequent recovery. Although this study did not identify any statistically significant effect of neurological status or management strategy on these parameters, rehabilitation was found to result in the improvement of these parameters in the later phase of recovery. Future studies are required to evaluate the exact causes of these alterations and the potential benefits of rehabilitation strategies and to minimize these changes.

show abstract

The recovery of damaged paraspinal muscles by posterior surgical treatment for patients with lumbar degenerative diseases and its clinical consequence

Abstract: There was reinnervation in not only denervated multifidus and erector spinae at 12 months following interspinous ligament stabilization but also in denervated erector spinae at 12 months following pedicle screw fixation with fusion.

Cited by 5 publications

References 18 publications

Microscopic Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis

Microscopic Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis

Lyophilized bovine acellular tendon linear fiber material for the reconstruction of attachment structure of paraspinous muscles: an animal in vivo study

Magnetic Resonance Imaging of Trunk Musculature and Intervertebral Discs in Patients with Spinal Cord Injury with Thoracolumbar Vertebral Fractures: A Prospective Study

Contact Info

Product

Resources

About