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

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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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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Validation of Psoas Muscle Index as a predictor of successful extubation in elderly intensive care patients: a retrospective cohort study

10.21203/rs.2.22396/v1 ◽

2020 ◽

Author(s):

Fumimasa Kobori ◽

Kazunari Azuma ◽

Shiro Mishima ◽

Jun Oda

Keyword(s):

Intensive Care ◽

Psoas Muscle ◽

Extubation Failure ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Predictive Values ◽

Failure Group ◽

Success Group ◽

Sensitivity Specificity

Abstract Background Extubation failure-associated factors haven't been investigated in elderly patients. We hypothesized that psoas cross-sectional area, an emerging indicator of frailty, can be a predictor of extubation outcomes. Methods This retrospective study analyzed data from patients admitted between January and April 2016 at the intensive care unit (ICU) of the Tokyo Medical University Hospital. Patients were considered eligible if aged ≥65 years, required intubation at the emergency room, and were admitted to ICU for <24 h. Overall, 39 ICU patients were eligible and categorized into two groups: extubation success (n = 24) and extubation failure (n = 15) groups. The psoas cross-sectional area was measured at the third lumbar level on computer tomography images. Regions of interest were drawn freehand to outline the left and right psoas by an emergency physician. The average left and right psoas cross-sectional areas, used as the patient’s psoas cross-sectional area, were calculated. Psoas Muscle Index (PMI) was defined as the psoas cross-sectional area/height 2 . Primary outcome was to evaluate differences between the psoas cross-sectional area and f(PMI) between the groups, if any. Secondary outcome was to derive cut-off values using ROC curves. Results Both groups were comparable in terms of demographic characteristics. Psoas cross-sectional area (success group, 1776.5 ± 498.2 mm 2 , failure group, 1391.2 ± 589.4 mm 2 ; p = 0.022) and PMI (success group, 1089 ± 270.7 mm 2 /m 2 , failure group, 889 ± 338.5 mm 2 /m 2 ; p = 0.032) were significantly greater in the success group than in the failure group. ROC curve of the psoas cross-sectional area and PMI were used to calculate sensitivity and speciﬁcity. ROC AUC was 0.74 for psoas cross-sectional area, and at a cut-off of 1260 points, the sensitivity, speciﬁcity, and positive and negative predictive values were 95.8%, 60.0%, 79.3%, and 90.0%, respectively. ROC AUC for PMI was 0.73, and at a cut-off of 812 points, the sensitivity, speciﬁcity, and positive and negative predictive values were 95.8%, 46.7%, 74.2%, and 87.5%, respectively. Conclusions The psoas cross-sectional area and PMI can predict extubation outcomes in elderly intensive care patients.

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Predictors of All-Cause Mortality after Endovascular Aneurysm Repair: Assessing the Role of Psoas Muscle Cross-Sectional Area

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2019.04.032 ◽

2019 ◽

Vol 30 (12) ◽

pp. 1972-1979 ◽

Cited By ~ 4

Author(s):

Timothy C. Huber ◽

Nicole Keefe ◽

James Patrie ◽

Margaret C. Tracci ◽

Daniel Sheeran ◽

...

Keyword(s):

Endovascular Aneurysm Repair ◽

Psoas Muscle ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

All Cause Mortality ◽

Aneurysm Repair ◽

Muscle Cross Sectional Area

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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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The significance of facet joint cross-sectional area on magnetic resonance imaging in relationship to cervical degenerative spondylolisthesis

The Spine Journal ◽

10.1016/j.spinee.2013.01.021 ◽

2013 ◽

Vol 13 (8) ◽

pp. 856-861 ◽

Cited By ~ 10

Author(s):

Christopher D. Chaput ◽

Jared J. Allred ◽

Jesse J. Pandorf ◽

Juhee Song ◽

Mark D. Rahm

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Facet Joint ◽

Degenerative Spondylolisthesis ◽

Cross Sectional Area ◽

Sectional Area ◽

Resonance Imaging ◽

Cross Sectional

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Psoas Muscle Volume as an Opportunistic Diagnostic Tool to Assess Sarcopenia in Patients with Hip Fractures: A Retrospective Cohort Study

Journal of Personalized Medicine ◽

10.3390/jpm11121338 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1338

Author(s):

Sang-Pil So ◽

Bum-Sik Lee ◽

Ji-Wan Kim

Keyword(s):

Skeletal Muscle ◽

Hip Fractures ◽

Diagnostic Tool ◽

Retrospective Cohort ◽

Psoas Muscle ◽

Cross Sectional Area ◽

Muscle Volume ◽

Sectional Area ◽

Muscle Area ◽

Cross Sectional

Purpose: This study aims to determine whether the psoas volume measured from a pelvic computed tomography (CT) could be a potential opportunistic diagnostic tool to measure muscle mass and sarcopenia in patients with hip fractures. Methods: This was a retrospective cohort study. In total; 57 consecutive patients diagnosed with hip fractures who underwent surgery were enrolled. A cross-sectional area of the psoas muscle was measured at the lumbar (L) 3 and L4 vertebrae from a pelvic CT for the diagnosis of hip fractures. The psoas muscle volume was calculated with a three-dimensional modeling software program. The appendicular skeletal muscle mass (ASM) and preoperative handgrip strength (HS) were measured. The correlations between the psoas muscle volume/area and ASM/HS were assessed. Data on patient demographics; postoperative complication; length of hospital stay; and Koval scores were also recorded and analyzed with respect to the psoas muscle area/volume. Results: The psoas muscle volume and adjusted values were significantly correlated with ASM; which showed a stronger correlation than the psoas muscle area did at the L3 or L4 level. HS was correlated with the psoas volume or adjusted values; but not with the cross-sectional area of the psoas muscle. Among the adjusted values; the psoas muscle volume adjusted for the patient’s height (m2) showed a strongest correlation with ASM and HS. The psoas muscle volume was not significantly correlated with postoperative complications or short-term functional outcomes. Conclusions: The psoas muscle volume measured from a pelvic CT for the diagnosis of hip fractures showed a stronger correlation with ASM and HS than the cross-sectional area did. Therefore; the psoas muscle volume could be a potential diagnostic tool to assess the quantity of the skeletal muscle in patients with hip fractures without an additional examination.

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Asymmetry of the cross-sectional area of paravertebral and psoas muscle in patients with degenerative scoliosis

European Spine Journal ◽

10.1007/s00586-013-2740-6 ◽

2013 ◽

Vol 22 (6) ◽

pp. 1332-1338 ◽

Cited By ~ 38

Author(s):

Hyoungmin Kim ◽

Choon-Ki Lee ◽

Jin S. Yeom ◽

Jae Hyup Lee ◽

Jae Hwan Cho ◽

...

Keyword(s):

Psoas Muscle ◽

Cross Sectional Area ◽

Sectional Area ◽

Degenerative Scoliosis ◽

Cross Sectional ◽

The Cross

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Anthropometric prediction of skeletal muscle cross-sectional area in persons with spinal cord injury

Journal of Applied Physiology ◽

10.1152/japplphysiol.01042.2016 ◽

2017 ◽

Vol 122 (5) ◽

pp. 1255-1261 ◽

Cited By ~ 6

Author(s):

Rodney C. Wade ◽

Ashraf S. Gorgey

Keyword(s):

Spinal Cord ◽

Field Equation ◽

Cross Sectional Area ◽

Anthropometric Measurements ◽

Sectional Area ◽

Resonance Imaging ◽

Cross Sectional ◽

Cord Injury ◽

Magnetic Resonance Imaging Mri ◽

Muscle Cross Sectional Area

Finding an accurate and affordable method to quantify muscle size following spinal cord injury (SCI) could provide benefits clinically and in research settings. The purpose of this study was to validate the use of anthropometric measurements vs. magnetic resonance imaging (MRI) to evaluate muscle cross-sectional area (CSA) and develop a field equation to predict muscle CSA specific to the SCI population. Twenty-two men with chronic (>1 yr) motor complete SCI participated in the current study. Anthropometric measurements, including midthigh circumference and anterior skinfold thickness (SFT), were taken on the right thigh. The anthropometric muscle cross-sectional area (muscle CSAanthro) was predicted using the following equation: muscle CSAanthro = π[ r − (SFT/2)]2, where r = thigh circumference/2π. MRI analysis yielded whole thigh CSA (thigh CSAMRI), midthigh muscle CSA (muscle CSAMRI), midthigh absolute muscle CSA after subtracting intramuscular fat and bone (muscle CSA-IMFMRI), subcutaneous adipose tissue (SATT) measured at one site as well as at four sites, and bone CSA. Anthropometric measurements were correlated to the thigh CSAMRI [ r2 = 0.90, standard error of the estimate (SEE) = 17.6 cm2, P < 0.001]. Muscle CSAanthro was correlated to muscle CSAMRI ( r2 = 0.78, SEE = 16.6 cm2, P < 0.001) and muscle CSA-IMFMRI ( r2 = 0.75, SEE = 17.6 cm2, P < 0.001). A single SFT was correlated to the polar four-site SATT ( r2 = 0.78, SEE = 0.37 cm, P < 0.001). The average femur CSA and average IMF CSA derived from MRI led to the following field equation: muscle CSApredicted = π[(Thighcircum/2π) − (SFT/2)]2 − 23.2. Anthropometric measurements of muscle CSA exhibited a good agreement with the gold standard MRI method and led to the development of a field equation for clinical use after accounting for bone and IMF. NEW & NOTEWORTHY This study used anthropometric measurements and magnetic resonance imaging (MRI) to evaluate muscle cross-sectional area (CSA) and developed a field equation to predict thigh muscle CSA specific to the spinal cord-injured (SCI) population. Anthropometric measurements were correlated to the whole thigh CSA and muscle CSA as measured by MRI. The correlations led to the development of a SCI-specific field equation that accounted for intramuscular fat and bone areas.

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