scholarly journals Correlation of Paraspinal Muscle Mass With Decompensation of Sagittal Adult Spinal Deformity After Setting of Fatigue Post 10-Minute Walk

Neurospine ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. 495-503
Author(s):  
Junseok Bae ◽  
Ashwin Sathe ◽  
Shih-Min Lee ◽  
Alexander A. Theologis ◽  
Vedat Deviren ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Fatty Infiltration ◽  
Psoas Muscle ◽  
Paraspinal Muscle ◽  
Muscle Quality ◽  
Cross Sectional ◽  
Before And After ◽  
Sagittal Deformity

Objective: The purpose of this study was to investigate the changes in spinopelvic parameters before and after the setting of muscle fatigue along with its correlation with pre-existing paraspinal and psoas muscle mass.Methods: Single-center retrospective review of prospectively collected data was conducted on 145-adults with symptomatic loss of lumbar lordosis (LL). Radiographs were taken before and after walking for 10 minutes. Magnetic resonance imaging was used to calculate paraspinal muscle (PSM) cross-sectional area (CSA), mean signal intensity, fatty infiltration (FI), and lean muscle mass at thoracolumbar junction (T12) and lower lumbar level (L4). Psoas CSA was calculated at L3. Patients were divided into 2 groups namely compensated sagittal deformity (CSD) (SVA ≤ 4 cm, PT > 20°) and decompensated sagittal deformity (DSD) (SVA > 4 cm, PT > 20°) based on prewalk measurements.Results: Initial mean SVA was 1.8 cm and 11 cm for CSD and DSD respectively (p < 0.01). After walking, significant deteriorations in SVA, PT–LL (p < 0.01) were observed in CSD without significant change in thoracic kyphosis (TK). All sagittal parameters in DSD deteriorated significantly. DSD group had significantly poorer PSM quality at T12 and L4 compared to CSD group. In CSD group, sagittal decompensation correlated with muscle quality, i.e. , decreases in LL (ΔLL) correlated with CSA of PSM/vertebral body (VB) at L4 (r = -0.412, p = 0.046) while increases in TK (ΔTK) correlated with CSA of PSM/VB at T12 (r = 0.477, p = 0.018). ΔSVA and ΔPT correlated with FI at L4 (r = 0.577, p = 0.003 and r = -0.407, p = 0.048, respectively). DSD group, had weak correlations (-0.3 < r < -0.1) between changes in sagittal and PSM parameters.Conclusion: PSM quality in adults with spinal deformity correlates with patients’ ability to maintain an upright posture and sagittal decompensation after walking for 10 minutes.

scholarly journals Correlation between Psoas Muscle Index and Degeneration of Spinal Back Muscle in Patients with Back Pain

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1189
Author(s):  
Donggyu Lee ◽  
Minsoo Kang
Keyword(s):  
Back Pain ◽  
Muscle Mass ◽  
Disc Degeneration ◽  
Muscle Atrophy ◽  
Chronic Back Pain ◽  
Fatty Infiltration ◽  
Psoas Muscle ◽  
Back Muscle ◽  
Back Muscles ◽  
Cross Sectional

Sarcopenia is characterized by a decline in systemic muscle mass and physical performance. Disc degeneration also causes back muscle atrophy. Therefore, we aimed to evaluate the influence of systemic muscle mass decline on back muscle atrophy and fatty infiltration compared to disc degeneration. We included 127 patients (65.54 ± 14.93 years) with back pain who underwent lumbar spine magnetic resonance imaging (MRI). Axial T2-weighted MRI data of the L4–5 and L5-S1 levels were used to measure the cross-sectional area (CSA) of the psoas and spinal muscles. The psoas index (cm2/m2) was used as a surrogate for systemic muscle mass. The Pfirrmann grading system was used to evaluate intervertebral disc degeneration. The functional area of the back muscles was calculated by subtracting the fat infiltration area from the CSA; the functional CSA ratio was calculated by dividing the functional CSA by the CSA. Image-processing software (ImageJ; National Institutes of Health, Bethesda, MD, USA) was used for analysis. Psoas index and aging significantly affected CSA and the ratio of functional CSA of the back muscles and multifidi. Disc degeneration did not significantly affect the back muscles beyond aging in patients with back pain. Males showed substantially higher CSA of the back muscles and multifidi than females; however, sex did not affect the functional CSA ratio of these muscles. Systemic muscle mass decline showed a more powerful influence on back muscle atrophy and fatty infiltration than disc degeneration. Therefore, proper evaluation of sarcopenia is needed for patients with chronic back pain and back muscle degeneration.

Association Between Deep Posterior Cervical Paraspinal Muscle Morphology and Clinical Features in Patients With Cervical Ossification of the Posterior Longitudinal Ligament

2021 ◽  
pp. 219256822198965
Author(s):  
Toru Doi ◽  
Nozomu Ohtomo ◽  
Fumihiko Oguchi ◽  
Keiichiro Tozawa ◽  
Hiroyuki Nakarai ◽  
...  
Keyword(s):  
Clinical Features ◽  
Fatty Infiltration ◽  
Neck Disability Index ◽  
Posterior Longitudinal Ligament ◽  
Paraspinal Muscle ◽  
Paraspinal Muscles ◽  
Muscle Area ◽  
Cross Sectional ◽  
Study Results ◽  
Neck Disability

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.

scholarly journals Reference Values for Skeletal Muscle Mass – Current Concepts and Methodological Considerations

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 755 ◽  
Author(s):  
Carina O. Walowski ◽  
Wiebke Braun ◽  
Michael J. Maisch ◽  
Björn Jensen ◽  
Sven Peine ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Reference Values ◽  
Skeletal Muscle Mass ◽  
Bioelectrical Impedance ◽  
Reference Population ◽  
Muscle Quality ◽  
Whole Body ◽  
Whole Body Imaging ◽  
Cross Sectional

Assessment of a low skeletal muscle mass (SM) is important for diagnosis of ageing and disease-associated sarcopenia and is hindered by heterogeneous methods and terminologies that lead to differences in diagnostic criteria among studies and even among consensus definitions. The aim of this review was to analyze and summarize previously published cut-offs for SM applied in clinical and research settings and to facilitate comparison of results between studies. Multiple published reference values for discrepant parameters of SM were identified from 64 studies and the underlying methodological assumptions and limitations are compared including different concepts for normalization of SM for body size and fat mass (FM). Single computed tomography or magnetic resonance imaging images and appendicular lean soft tissue by dual X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) are taken as a valid substitute of total SM because they show a high correlation with results from whole body imaging in cross-sectional and longitudinal analyses. However, the random error of these methods limits the applicability of these substitutes in the assessment of individual cases and together with the systematic error limits the accurate detection of changes in SM. Adverse effects of obesity on muscle quality and function may lead to an underestimation of sarcopenia in obesity and may justify normalization of SM for FM. In conclusion, results for SM can only be compared with reference values using the same method, BIA- or DXA-device and an appropriate reference population. Limitations of proxies for total SM as well as normalization of SM for FM are important content-related issues that need to be considered in longitudinal studies, populations with obesity or older subjects.

scholarly journals Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population

2020 ◽  
Vol 9 (5) ◽  
pp. 1580
Author(s):  
Mateu Serra-Prat ◽  
Isabel Lorenzo ◽  
Mònica Papiol ◽  
Elisabet Palomera ◽  
Maria Bartolomé ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Water Content ◽  
Muscle Mass ◽  
Lean Mass ◽  
Gait Speed ◽  
Bioelectrical Impedance ◽  
Intracellular Water ◽  
Muscle Quality ◽  
Timed Up And Go ◽  
Cross Sectional

Background: In aged populations, muscle strength depends more on muscle quality than on muscle quantity, while all three are criteria for the diagnosis of sarcopenia. Intracellular water content (ICW) in lean mass (LM) has been proposed as an indicator of muscle quality related to muscle strength in older people. Objectives: To evaluate the relationship between the ICW/LM ratio, muscle strength and indicators of functional performance in obese older adults, and to assess the value of the ICW/LM ratio as an indicator of muscle quality. Methodology: Design: cross-sectional study. Population: persons aged 65–75 years with a body mass index of 30–39 kg/m2. ICW and LM were estimated by bioelectrical impedance. Hand grip, gait speed, unipedal stance test, timed up-and-go (TUG) test, Barthel score and frailty (Fried criteria) were assessed. Sarcopenia was established according to EWGSOP2 criteria. Results: Recruited were 305 subjects (66% women), mean age 68 years. The ICW/LM ratio correlated with the TUG test, gait speed and grip strength, and was also associated with sex, the unipedal stance test and frailty. Independently of age, sex and muscle mass, the ICW/LM ratio was related with gait speed, the TUG test and unipedal stance capacity. One person (0.3%) had sarcopenia defined as low muscle strength and low muscle mass, while 25 people (8.2%) had sarcopenia defined as low muscle strength and poor muscle quality (ICW/LM). With this last definition, sarcopenia was related to frailty, gait speed and the TUG test. Conclusions: ICW content in LM could be a useful muscle quality indicator for defining sarcopenia. However, more studies are required to confirm our findings for other populations.

scholarly journals Assessment of Muscle Quality and Quantity for the Diagnosis of Sarcopenia Using Mid-Thigh Computed Tomography : A Cohort Study

2020 ◽  
Author(s):  
Hiroki Oba ◽  
Yasumoto Matsui ◽  
Hidenori Arai ◽  
Tsuyoshi Watanabe ◽  
Hiroki Iida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Motor Function ◽  
Mass Measurement ◽  
Muscle Quality ◽  
Cross Sectional ◽  
Skeletal Mass ◽  
Low Mass

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength, and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We compared computed tomography (CT) with various motor function tests to determine the validity of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups: normal, low muscle mass (low mass), poor muscle function/strength (poor function), and sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. CSA was significantly reduced both in men and women with low mass and sarcopenia group (p < 0.01), whereas CTV was significantly lower in men with sarcopenia group and in women with poor function and sarcopenia group (p < 0.01).ConclusionsCSA mostly reflects muscle strength, whereas CTV mostly reflects physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. Thus, CT is thought to be useful for the assessment of motor function and diagnosis of sarcopenia.

scholarly journals Skeletal muscle quality affects patient outcomes in acute type A aortic dissection

2020 ◽  
Vol 30 (5) ◽  
pp. 739-745
Author(s):  
Toshihito Gomibuchi ◽  
Tatsuichiro Seto ◽  
Shuji Chino ◽  
Toru Mikoshiba ◽  
Masaki Komatsu ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Risk Factor ◽  
Aortic Dissection ◽  
Muscle Mass ◽  
Daily Living ◽  
Psoas Muscle ◽  
Muscle Quality ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
The Mean

Abstract OBJECTIVES Although skeletal muscle quantity is linked to surgical outcomes, quality remains unexamined. In this study, we evaluated whether skeletal muscle quality and quantity could predict surgical outcomes in acute type A aortic dissection (ATAAD). METHODS Skeletal muscle quality and quantity were evaluated using computed tomography (CT) values and the psoas muscle mass index, respectively. From May 2004 to December 2017, 324 ATAAD patients underwent aortic replacement after CT scans and psoas muscle mass index measurements. Patients were grouped into intramuscular fat (IMF; n = 55) and non-IMF (n = 269) deposition groups. RESULTS The mean ages of the patients were 72.3 ± 9.7 and 66.8 ± 12.1 years (P = 0.002), and hospital mortality rates were 3.6% (2/55) and 7.4% (20/269; P = 0.393) for IMF and non-IMF deposition groups, respectively. IMF deposition was a risk factor for a deterioration in activities of daily living at discharge by multivariable analysis [odds ratio 0.33, 95% confidence interval (CI) 0.16–0.69; P = 0.003]. The mean follow-up was 43.9 ± 36.8 months. The 5-year survival was significantly worse for the IMF deposition group (IMF 73.8% vs non-IMF 88.2%; P = 0.010). The multivariable Cox proportional hazard analysis showed that IMF deposition significantly predicted poor survival (hazard ratio 3.26, 95% CI 1.47–7.24; P = 0.004), unlike psoas muscle mass index and age. CONCLUSIONS Skeletal muscle quality, defined by IMF deposition, was an independent predictor of overall survival and postoperative activities of daily living dependence risk in patients undergoing surgery for ATAAD. Thus, IMF deposition may be an additional risk factor for estimating late outcomes of ATAAD surgery.

Quality metrics in adult spinal deformity surgery over the last decade: a combined analysis of the largest prospective multicenter data sets

2021 ◽  
pp. 1-9
Author(s):  
Ferran Pellisé ◽  
Miquel Serra-Burriel ◽  
Alba Vila-Casademunt ◽  
Jeffrey L. Gum ◽  
Ibrahim Obeid ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Deformity ◽  
Oswestry Disability Index ◽  
Adult Spinal Deformity ◽  
Research Society ◽  
Data Sets ◽  
Scoliosis Research Society ◽  
Sagittal Deformity

OBJECTIVE The reported rate of complications and cost of adult spinal deformity (ASD) surgery, associated with an exponential increase in the number of surgeries, cause alarm among healthcare payers and providers worldwide. The authors conjointly analyzed the largest prospective available ASD data sets to define trends in quality-of-care indicators (complications, reinterventions, and health-related quality of life [HRQOL] outcomes) since 2010. METHODS This is an observational prospective longitudinal cohort study. Patients underwent surgery between January 2010 and December 2016, with > 2 years of follow-up data. Demographic, surgical, radiological, and HRQOL (i.e., Oswestry Disability Index, SF-36, Scoliosis Research Society-22r) data obtained preoperatively and at 3, 6, 12, and 24 months after surgery were evaluated. Trends and changes in indicators were analyzed using local regression (i.e., locally estimated scatterplot smoothing [LOESS]) and adjusted odds ratio (OR). RESULTS Of the 2286 patients included in the 2 registries, 1520 underwent surgery between 2010 and 2016. A total of 1151 (75.7%) patients who were treated surgically at 23 centers in 5 countries met inclusion criteria. Patient recruitment increased progressively (2010–2011 vs 2015–2016: OR 1.64, p < 0.01), whereas baseline clinical characteristics (age, American Society of Anesthesiologists class, HRQOL scores, sagittal deformity) did not change. Since 2010 there has been a sustained reduction in major and minor postoperative complications observed at 90 days (major: OR 0.59; minor: OR 0.65; p < 0.01); at 1 year (major: OR 0.52; minor: 0.75; p < 0.01); and at 2 years of follow-up (major: OR 0.4; minor: 0.80; p < 0.01) as well as in the 2-year reintervention rate (OR 0.41, p < 0.01). Simultaneously, there has been a slight improvement in the correction of sagittal deformity (i.e., pelvic incidence–lumbar lordosis mismatch: OR 1.11, p = 0.19) and a greater gain in quality of life (i.e., Oswestry Disability Index 26% vs 40%, p = 0.02; Scoliosis Research Society-22r, self-image domain OR 1.16, p = 0.13), and these are associated with a progressive reduction of surgical aggressiveness (number of fused segments: OR 0.81, p < 0.01; percent pelvic fixation: OR 0.66, p < 0.01; percent 3-column osteotomies: OR 0.63, p < 0.01). CONCLUSIONS The best available data show a robust global improvement in quality metrics in ASD surgery over the last decade. Surgical complications and reoperations have been reduced by half, while improvement in disability increased and correction rates were maintained, in patients with similar baseline characteristics.

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