Relation of Deep Paraspinal Muscles' Cross-Sectional Area of the Cervical Spine and Bone Union in Anterior Cervical Decompression and Fusion: A Retrospective Study

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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Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots: a 5-year follow-up

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2551-y ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Tuomas Honkanen ◽

Matti Mäntysaari ◽

Tuomo Leino ◽

Janne Avela ◽

Liisa Kerttula ◽

...

Keyword(s):

Muscle Strength ◽

Cross Sectional Area ◽

Sectional Area ◽

Paraspinal Muscles ◽

Cross Sectional

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A clinical prediction rule to identify difficult intubation in children with Robin sequence requiring mandibular distraction osteogenesis based on craniofacial CT measures

BMC Anesthesiology ◽

10.1186/s12871-019-0889-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Zhe Mao ◽

Na Zhang ◽

Yingqiu Cui

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Difficult Intubation ◽

Prediction Rule ◽

Clinical Prediction Rule ◽

Cross Sectional Area ◽

Sectional Area ◽

Clinical Prediction ◽

Cross Sectional ◽

Mandibular Distraction Osteogenesis

Abstract Background Airway management is challenging in children with Robin sequence (RS) requiring mandibular distraction osteogenesis (MDO). We derived and validated a prediction rule to identify difficult intubation before MDO for children with RS based on craniofacial computed tomography (CT) images. Method This was a retrospective study of 69 children with RS requiring MDO from November 2016 to June 2018. Multiple CT imaging parameters and baseline characteristic (sex, age, gestational age, body mass index [BMI]) were compared between children with normal and difficult intubation according to Cormack−Lehane classification. A clinical prediction rule was established to identify difficult intubation using group differences in CT parameters (eleven distances, six angles, one section cross-sectional area, and three segment volumes) and clinicodemographic characteristics. Predictive accuracy was evaluated by receiver operating characteristic (ROC) curve analysis. Results The overall incidence of difficult intubation was 56.52%, and there was no significant difference in sex ratio, age, weight, height, BMI, or gestational age between groups. The distance between the root of the tongue and posterior pharyngeal wall was significantly shorter, the bilateral mandibular angle shallower, and the cross-sectional area at the epiglottis tip smaller in the difficult intubation group. A clinical prediction rule based on airway cross-sectional area at the tip of the epiglottis was established. Area > 36.97 mm2 predicted difficult intubation while area < 36.97 mm2 predicted normal intubation with 100% sensitivity, 62.5% specificity, 78.6% positive predictive value, and 100% negative predictive value (area under the ROC curve = 0.8125). Conclusion Computed tomography measures can objectively evaluate upper airway morphology in patients with RS for prediction of difficult intubation. If validated in a larger series, the measures identified could be incorporated into airway assessment tools to guide treatment decisions. This was a retrospective study and was granted permission to access and use these medical records by the ethics committee of Guangzhou Women and Children’s Medical Center. Trials registration Registration No. ChiCTR1800018252, NaZhang, Sept 7 2018.

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Severe Lumbar Disability Is Associated With Decreased Psoas Cross-Sectional Area in Degenerative Spondylolisthesis

Global Spine Journal ◽

10.1177/2192568218765399 ◽

2018 ◽

Vol 8 (7) ◽

pp. 716-721 ◽

Cited By ~ 5

Author(s):

Scott C. Wagner ◽

Arjun S. Sebastian ◽

James C. McKenzie ◽

Joseph S. Butler ◽

Ian D. Kaye ◽

...

Keyword(s):

Lumbar Fusion ◽

Degenerative Spondylolisthesis ◽

Psoas Muscle ◽

Cross Sectional Area ◽

Severe Disability ◽

Sectional Area ◽

Paraspinal Muscles ◽

Cross Sectional ◽

Potential Association ◽

Magnetic Resonance Imaging Mri

Study Design: Retrospective cohort. Objectives: Alterations in lumbar paraspinal muscle cross-sectional area (CSA) may correlate with lumbar pathology. The purpose of this study was to compare paraspinal CSA in patients with degenerative spondylolisthesis and severe lumbar disability to those with mild or moderate lumbar disability, as determined by the Oswestry Disability Index (ODI). Methods: We retrospectively reviewed the medical records of 101 patients undergoing lumbar fusion for degenerative spondylolisthesis. Patients were divided into ODI score ≤40 (mild/moderate disability, MMD) and ODI score >40 (severe disability, SD) groups. The total CSA of the psoas and paraspinal muscles were measured on preoperative magnetic resonance imaging (MRI). Results: There were 37 patients in the SD group and 64 in the MMD group. Average age and body mass index were similar between groups. For the paraspinal muscles, we were unable to demonstrate any significant differences in total CSA between the groups. Psoas muscle CSA was significantly decreased in the SD group compared with the MMD group (1010.08 vs 1178.6 mm2, P = .041). Multivariate analysis found that psoas CSA in the upper quartile was significantly protective against severe disability ( P = .013). Conclusions: We found that patients with severe lumbar disability had no significant differences in posterior lumbar paraspinal CSA when compared with those with mild/moderate disability. However, severely disabled patients had significantly decreased psoas CSA, and larger psoas CSA was strongly protective against severe disability, suggestive of a potential association with psoas atrophy and worsening severity of lumbar pathology.

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