P47. Preoperative Cross-sectional Lumbar Paraspinal Muscle Area as a Predictor of Clinical Outcomes Following Lumbar Laminectomy

Study Design: A retrospective observational study. Objective: To clarify the association of the paraspinal muscle area and composition with clinical features in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Methods: Consecutive patients with cervical OPLL who underwent cervical magnetic resonance imaging (MRI) before surgery were reviewed. The cross-sectional area (CSA) and fatty infiltration ratio (FI%) of deep posterior cervical paraspinal muscles (multifidus [MF] and semispinalis cervicis [SCer]) were examined. We assessed the association of paraspinal muscle measurements with the clinical characteristics and clinical outcomes, such as Neck Disability Index (NDI) score. Moreover, we divided the patients into 2 groups according to the extent of the ossified lesion (segmental and localized [OPLL-SL] and continuous and mixed [OPLL-CM] groups) and compared these variables between the 2 groups. Results: 49 patients with cervical OPLL were enrolled in this study. The FI% of the paraspinal muscles was significantly associated with the number of vertebrae ( ρ = 0.283, p = 0.049) or maximum occupancy ratio of OPLL ( ρ = 0.397, p = 0.005). The comparative study results indicated that the NDI score was significantly worse (OPLL-SL, 22.9 ± 13.7 vs. OPLL-CM, 34.4 ± 13.7) and FI% of SCer higher (OPLL-SL, 9.1 ± 1.7% vs. OPLL-CM, 11.1 ± 3.7%) in the OPLL-CM group than those in the OPLL-SL group. Conclusions: Our results suggest that OPLL severity may be associated with fatty infiltration of deep posterior cervical paraspinal muscles, which could affect neck disability in patients with cervical OPLL.

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Longitudinal study of risk factors for decreased cross-sectional area of psoas major and paraspinal muscle in 1849 individuals

Scientific Reports ◽

10.1038/s41598-021-96448-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yoichi Murata ◽

Eiichiro Nakamura ◽

Manabu Tsukamoto ◽

Toru Nakagawa ◽

Masaru Takeda ◽

...

Keyword(s):

Risk Factors ◽

Paraspinal Muscle ◽

Low Back ◽

Muscle Loss ◽

Healthy Individuals ◽

Major Area ◽

Muscle Area ◽

Cross Sectional ◽

Risk Of Falls ◽

Psoas Major

AbstractThis 10-year retrospective observational study investigated longitudinal losses in psoas major and paraspinal muscle area in 1849 healthy individuals (1690 male, 159 female) screened using computed tomography. Logistic regression analysis revealed significant decreases in psoas major and paraspinal muscle area at 10 years relative to the baseline area regardless of age or sex, starting at 30 years of age. Only aging [≥ 50 s (odds ratio [OR]: 1.72; 95% confidence interval [CI] 1.05–2.84; p = 0.03) and ≥ 60 s (OR: 2.67; 95% CI 1.55–4.60; p < 0.001)] was a risk factor for decreases in psoas major area. Age ≥ 60 years (OR: 2.05; 95% CI 1.24–3.39; p = 0.005), body mass index ≥ 25 kg/m2 (OR: 1.32; 95% CI 1.01–1.73; p = 0.04), and visceral fat ≥ 100 cm2 (OR: 1.61; 95% CI 1.20–2.15; p = 0.001) were risk factors for decreases in paraspinal muscle area. Physical activity ≥ 900 kcal/week (OR: 0.68; 95% CI 0.50–0.94; p = 0.02) attenuated paraspinal muscle area loss in male. Our study demonstrated that walking > 45 min daily (Calories = METs (walking: 3.0) × duration of time (h) × weight (60 kg) × 1.05) can reduce paraspinal muscle loss, which may in turn decrease the risk of falls, low-back pain, and sarcopenia.

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Longitudinal Analysis of Paraspinal Muscle Cross-Sectional Area During Early Adulthood – A 10-Year Follow-Up MRI Study

Scientific Reports ◽

10.1038/s41598-019-56186-4 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Teemu Mäki ◽

Petteri Oura ◽

Markus Paananen ◽

Jaakko Niinimäki ◽

Jaro Karppinen ◽

...

Keyword(s):

Early Adulthood ◽

Population Based ◽

Cross Sectional Area ◽

Erector Spinae ◽

Paraspinal Muscle ◽

Muscle Size ◽

Sectional Area ◽

Muscle Area ◽

Cross Sectional

AbstractOnly a few previous studies have investigated paraspinal musculature (i.e., multifidus (MF), psoas major (PSM), erector spinae (ES)) in longitudinal, population-based settings. This study aimed to evaluate changes in the cross-sectional area (CSA) of the paraspinal muscles between the ages of 20 and 30 years. The study population consisted of a sub-cohort from the Northern Finland Birth Cohort 1986 (n = 298; 156 men, 142 women). Baseline magnetic resonance imaging was performed at a mean age of 21.3 years and follow-up imaging at 30.6 years. The CSA measurements were performed by tracing the paraspinal muscle outlines individually (MF, ES, PM) and all combined (total muscle area (TMA)) at the L4 cranial endplate level. The longitudinal data analysis was performed using generalized estimating equations modelling. The CSA of MF and ES increased during the follow-up among both sexes (men: MF + 5.7%, p < 0.001; ES + 2.7%, p = 0.001; and women: MF + 10.5%, p < 0.001; ES 9.2%, p = 0.001). The CSA of PM decreased among men (PM −4.0%, p < 0.001) but not among women (PM + 0.5%, p = 0.553). TMA increased significantly only among women (men: +0.5%, p = 0.425; women: +6.5%, p < 0.001). The increases in ES and TMA were more distinct among women than men (p < 0.001). Our study demonstrated clear age- and sex-related changes in paraspinal muscle size in early adulthood.

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Risk Factors for Decrease in The Cross-Sectional Area of the Paraspinal Muscle in 1,849 Individuals: A 10-Year Longitudinal Study

10.21203/rs.3.rs-195834/v1 ◽

2021 ◽

Author(s):

Yoichi Murata ◽

Eiichiro Nakamura ◽

Manabu Tsukamoto ◽

Toru Nakagawa ◽

Masaru Takeda ◽

...

Keyword(s):

Risk Factors ◽

Study Data ◽

Paraspinal Muscle ◽

Low Back ◽

Muscle Loss ◽

Muscle Area ◽

Cross Sectional ◽

Factors Associated ◽

Risk Of Falls ◽

Psoas Major

Abstract We investigated longitudinal losses of paraspinal muscle area in healthy individuals in a 10-year longitudinal retrospective observational study. Data from 1,849 individuals (1,690 men, 159 women) screened using computed tomography were examined. Logistic regression was performed to determine risk factors associated with paraspinal muscle area decreases; the area was significantly decreased at 10 years compared with the area at baseline regardless of age or sex, starting at 30 years of age. In regression analysis, only aging (≥50s [odds ratio [OR], 1.72; 95% confidence interval [CI], 1.05–2.84; p=0.03] and ≥60s [OR, 2.67; 95% CI, 1.55–4.60; p<0.001]) was a risk factor for psoas major area decreases. Age ≥60 years (OR, 2.05; 95% CI, 1.24–3.39; p=0.005), body mass index ≥25 kg/m2 (OR, 1.32; 95% CI, 1.01–1.73; p=0.04), and visceral fat ≥100 cm2 (OR, 1.61; 95% CI, 1.20–2.15; p=0.001) were risk factors for erector muscle area decreases; physical activity ≥900 kcal/week (OR, 0.68; 95% CI, 0.50–0.94; p=0.02) reduced erector muscle area loss in males. Our study demonstrated that walking >45 minutes daily could reduce paraspinal muscle loss, which in turn can decrease the risk of falls and low-back pain and might eventually help prevent sarcopenia.

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Cross-sectional observational study of epidemiology of COVID-19 and clinical outcomes of hospitalised patients in North West London during March and April 2020

BMJ Open ◽

10.1136/bmjopen-2020-044384 ◽

2021 ◽

Vol 11 (2) ◽

pp. e044384

Author(s):

Guduru Gopal Rao ◽

Alexander Allen ◽

Padmasayee Papineni ◽

Liyang Wang ◽

Charlotte Anderson ◽

...

Keyword(s):

Mechanical Ventilation ◽

Clinical Outcomes ◽

Severe Infection ◽

Older Age ◽

Cross Sectional ◽

North West ◽

Icu Admission ◽

Risk Of Death ◽

Hospitalised Patients ◽

Increased Risk

ObjectiveThe aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.DesignObservational cohort study.SettingLondon North West Healthcare NHS Trust (LNWH).ParticipantsPatients tested and/or admitted for COVID-19 at LNWH during March and April 2020Main outcome measuresDescriptive and analytical epidemiology of demographic and clinical outcomes (intensive care unit (ICU) admission, mechanical ventilation and mortality) of those who tested positive for COVID-19.ResultsThe outbreak began in the first week of March 2020 and reached a peak by the end of March and first week of April. In the study period, 6183 tests were performed in on 4981 people. Of the 2086 laboratory confirmed COVID-19 cases, 1901 were admitted to hospital. Older age group, men and those of black or Asian minority ethnic (BAME) group were predominantly affected (p<0.05). These groups also had more severe infection resulting in ICU admission and need for mechanical ventilation (p<0.05). However, in a multivariate analysis, only increasing age was independently associated with increased risk of death (p<0.05). Mortality rate was 26.9% in hospitalised patients.ConclusionThe findings confirm that men, BAME and older population were most commonly and severely affected groups. Only older age was independently associated with mortality.

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Related Factors and Clinical Outcomes of Osteosarcopenia: A Narrative Review

Nutrients ◽

10.3390/nu13020291 ◽

2021 ◽

Vol 13 (2) ◽

pp. 291

Author(s):

Tatsuro Inoue ◽

Keisuke Maeda ◽

Ayano Nagano ◽

Akio Shimizu ◽

Junko Ueshima ◽

...

Keyword(s):

Older Adults ◽

Longitudinal Studies ◽

Clinical Outcomes ◽

Daily Living ◽

Community Dwelling ◽

Related Factors ◽

Cross Sectional ◽

Meta Analyses ◽

Community Dwelling Older Adults

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.

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Radiological Assessment of Postoperative Paraspinal Muscle Changes After Lumbar Interbody Fusion With or Without Minimally Invasive Techniques

Global Spine Journal ◽

10.1177/2192568221994794 ◽

2021 ◽

pp. 219256822199479

Author(s):

Keigo Kameyama ◽

Tetsuro Ohba ◽

Tomoka Endo ◽

Marina Katsu ◽

Fujita Koji ◽

...

Keyword(s):

Minimally Invasive ◽

Interbody Fusion ◽

Cross Sectional Area ◽

Paraspinal Muscle ◽

Lumbar Interbody Fusion ◽

Sectional Area ◽

Paraspinal Muscles ◽

Cross Sectional ◽

Muscle Density ◽

Muscle Changes

Study Design: Retrospective cohort study. Background: Percutaneous pedicle screws (PPS) have the advantage of being able to better preserve the paraspinal muscles when compared with a traditional open approach. However, the nature of changes in postoperative paraspinal muscle after damage by lumbar fusion surgery has remained largely unknown. It is clinically important to clarify and compare changes in paraspinal muscles after the various surgeries. Objective: (1) To determine postoperative changes of muscle density and cross-sectional area using computed tomography (CT), and (2) to compare paraspinal muscle changes after posterior lumbar interbody fusion (PLIF) with traditional open approaches and minimally invasive lateral lumbar interbody fusions (LLIF) with PPS. Methods: We included data from 39 consecutive female patients who underwent open PLIF and 23 consecutive patients who underwent single-staged treatment with LLIF followed by posterior PPS fixation at a single level (L4-5). All patients underwent preoperative, 6 months postoperative, and 1-year postoperative CT imaging. Measurements of the cross-sectional area (CSA) and muscle densities of paraspinal muscles were obtained using regions of interest defined by manual tracing. Results: We did not find any decrease of CSA in any paraspinal muscles. We did find a decrease of muscle density in the multifidus at 1 year after surgery in patients in the PILF group, but not in those in LLIF/PPS group. Conclusions: One year after surgery, a significant postoperative decrease of muscle density of the multifidi was observed only in patients who underwent open PLIF, but not in those who underwent LLIF/PPS.

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Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2021-000662 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000662

Author(s):

Sen Yagi ◽

Shinya Furukawa ◽

Kana Shiraishi ◽

Yu Hashimoto ◽

Kazuhiro Tange ◽

...

Keyword(s):

Ulcerative Colitis ◽

Serum Albumin ◽

Clinical Outcomes ◽

Clinical Remission ◽

Acute Inflammation ◽

Japanese Patients ◽

Cross Sectional Study ◽

Mucosal Healing ◽

High Serum ◽

Cross Sectional

ObjectiveSerum albumin is used as a marker of acute inflammation. Several studies have addressed the association between serum albumin and clinical outcome in patients with ulcerative colitis (UC). While mucosal healing (MH) has been indicated as the therapeutic goal for UC, the association between serum albumin and MH remains unclear. We evaluated this issue in patients with UC overall and explored whether duration of UC affected this association.DesignThis cross-sectional study recruited consecutive patients with UC. Study subjects consisted of 273 Japanese patients with UC. Serum albumin was divided into tertiles based on its distribution in all study subjects. One endoscopy specialist was responsible for measuring partial MH and MH, which were defined as a Mayo endoscopic subscore of 0–1 and 0, respectively. The association between serum albumin and clinical outcomes was assessed by multivariate logistic regression.ResultsRates of clinical remission, partial MH and MH were 57.9%, 63% and 26%, respectively. Only high serum albumin (>4.4 mg/dL) was significantly positively associated with MH (OR 2.29 (95% CI: 1.03 to 5.29), p for trend=0.043). In patients with short UC duration (<7 years) only, high serum albumin was significantly positively associated with MH and clinical remission. In patients with long UC duration (≥7 years), in contrast, no association between serum albumin and clinical outcomes was found.ConclusionIn Japanese patients with UC, serum albumin was significantly positively associated with MH. In patients with short UC duration, serum albumin might be a useful complementary marker for MH.

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