scholarly journals Association of Lumbar Paraspinal Muscle Morphometry with Degenerative Spondylolisthesis

2021 ◽  
Vol 18 (8) ◽  
pp. 4037
Author(s):  
Eun Taek Lee ◽  
Seung Ah Lee ◽  
Yunsoo Soh ◽  
Myung Chul Yoo ◽  
Jun Ho Lee ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Protective Factor ◽  
Degenerative Spondylolisthesis ◽  
Fatty Degeneration ◽  
Erector Spinae ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Fat Infiltration ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

The objective of this study was to assess the cross-sectional areas (CSA) of lumbar paraspinal muscles and their fatty degeneration in adults with degenerative lumbar spondylolisthesis (DLS) diagnosed with chronic radiculopathy, compare them with those of the same age- and sex-related groups with radiculopathy, and evaluate their correlations and the changes observed on magnetic resonance imaging (MRI). This retrospective study included 62 female patients aged 65–85 years, who were diagnosed with lumbar polyradiculopathy. The patients were divided into two groups: 30 patients with spondylolisthesis and 32 patients without spondylolisthesis. We calculated the CSA and fatty degeneration of the erector spinae (ES) and multifidus (MF) on axial T2-weighted magnetic resonance (MR) images from the inferior end plate of the L4 vertebral body levels. The functional CSA (FCSA): CSA ratio, skeletal muscle index (SMI), and MF CSA: ES CSA ratio were calculated and compared between the two groups using an independent t-test. We performed logistic regression analysis using spondylolisthesis as the dependent variable and SMI, FCSA, rFCSA, fat infiltration rate as independent variables. The result showed more fat infiltration of MF in patients with DLS (56.33 vs. 44.66%; p = 0.001). The mean FCSA (783.33 vs. 666.22 mm2; p = 0.028) of ES muscle was a statistically larger in the patients with DLS. The ES FCSA / total CSA was an independent predictor of lumbar spondylolisthesis (odd ratio =1.092, p = 0.016), while the MF FCSA / total CSA was an independent protective factor (odd ratio =0.898, p = 0.002)

scholarly journals GUIDELINES FOR TREATMENT OF DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

2016 ◽  
Vol 15 (3) ◽  
pp. 238-240 ◽  
Author(s):  
CARMEN YOSSALETH BRICEÑO-GONZÁLEZ ◽  
ADRIÁN GARCÍA-SUAREZ ◽  
EULALIO ELIZALDE-MARTÍNEZ ◽  
MARIO ANTONIO DOMÍNGUEZ-DE LA PEÑA ◽  
RUBÉN TORRES-GONZÁLEZ ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Treatment Options ◽  
Cross Sectional ◽  
Practice Guide ◽  
Transpedicular Instrumentation ◽  
Clinical Presentations ◽  
Study Results ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Axial Symptoms ◽  
Lumbar Spondylolisthesis

ABSTRACT Objectives: To determine the standard of treatment of degenerative lumbar spondylolisthesis in its different clinical presentations in UMAE Dr. Victorio de la Fuente Narváez. Methods: Six cases found in the literature were presented to 36 experts in spine surgery, along with treatment options, to thereby obtain a standard prescription for the treatment of degenerative lumbar spondylolisthesis. Analytical observational cross-sectional descriptive study. Results: It was found that the treatment of choice in cases of degenerative lumbar spondylolisthesis with axial symptoms is conservative. The surgical treatment of choice for both stable and unstable patients with radiculopathy and/or claudication is decompression + posterolateral graft + transpedicular instrumentation + discectomy (graft). Conclusions: We managed to define the degenerative lumbar spondylolisthesis treatment guidelines in our unit, which can serve as a basis for the development of a clinical practice guide.

scholarly journals Changes in Cross-sectional Areas of Posterior Extensor Muscles in Thoracic Spine: A 10-year Longitudinal MRI Study

2021 ◽  
Author(s):  
Hitoshi Umezawa ◽  
Kenshi Daimon ◽  
Hirokazu Fujiwara ◽  
Yuji Nishiwaki ◽  
Takehiro Michikawa ◽  
...  
Keyword(s):  
Cross Section ◽  
Disc Degeneration ◽  
Thoracic Spine ◽  
Erector Spinae ◽  
Related Factors ◽  
Cross Sectional ◽  
Fat Infiltration ◽  
Extensor Muscles ◽  
The Cross ◽  
Muscle Fat Infiltration

Abstract This study aimed to examine changes in the cross-sectional areas (CSAs) of posterior extensor muscles in the thoracic spine over 10 years and identify related factors. The subjects of this study were 85 volunteers (mean age: 44.8 ± 11.5) and the average follow-up period was about 10 years. The CSAs of the transversospinalis muscles, erector spinae muscles, and total CSAs of the extensor muscles from T1/2 to T11/12 were measured on MRI. The extent of muscle fat infiltration was assessed by the signal intensity (luminance) of the extensor muscles’ total cross section compared to a section of pure muscle. Associations of age, sex, body mass index, lifestyle, back pain, neck pain, neck stiffness, and intervertebral disc degeneration with the 10-year CSAs changes and muscle fat infiltration were examined by Poisson regression analysis. The mean CSAs of all index muscles increased significantly. Exercise habit was associated with increased CSAs of the erector spinae muscles and the total area of the extensor muscles. The cross-section mean luminance increased significantly from baseline, indicating a significant increase of fat infiltration in the posterior extensor muscles. Progression of disc degeneration was negatively associated with the increase of fat infiltration in the total extensor muscles.

Comparison of Paraspinal Muscle Degeneration and Decompression Effect Between Conventional Open and Minimal Invasive Approaches for Posterior Lumbar Spine Surgery: a prospective cohort study.

2020 ◽  
Author(s):  
CHEN-JU FU ◽  
Wen-Chien Chen ◽  
Meng-Ling Lu ◽  
Chih-Hsiu Cheng ◽  
Chi-Chien Niu
Keyword(s):  
Transforaminal Lumbar Interbody Fusion ◽  
Fatty Degeneration ◽  
Minimal Invasive ◽  
Erector Spinae ◽  
Lumbar Spine Surgery ◽  
Paraspinal Muscles ◽  
Adjacent Level ◽  
Cross Sectional ◽  
Erector Spinae Muscle ◽  
Dural Sac

Abstract Background Posterior Instrumented Transforaminal Lumbar Interbody Fusion (TLIF) is used to treat spinal stenosis. Minimally invasive surgery (MIS) can cause less muscle injury than conventional open surgery (COS) The purpose of this study was to compare the degree of postoperative fatty degeneration in the paraspinal muscles and the spinal decompression between COS and MIS based on magnetic resonance imaging (MRI). Methods Forty-six patients received TLIF (21 COS, 25 MIS) from February 2016 to January 2017. Lumbar MRI was performed within 3 months before surgery and 1 year after surgery. The postoperative muscle-fat-index (MFI) change of the paraspinal muscles (multifidus and erector spinae) and the dural sac cross-sectional area (DSCAS) change were compared between the 2 groups. Results The average MFI change at L2-S1 erector spinae muscle was significantly greater in the COS group (27.37 ± 21.37% vs. 14.13 ± 19.19%, P = 0.044). A significant MFI change difference between the COS and MIS group was also found in the erector spinae muscle at the caudal adjacent level (54.47 ± 37.95% vs. 23.60 ± 31.59%, P = 0.016). No significant differences at the operated and cranial adjacent level were found. DSCSA improvement after surgery was significantly greater in the COS group (128.15 ± 39.83 mm2 vs. 78.15 ± 38.5 mm2, P = 0.0005) Conclusion COS is associated with more prominent fatty degeneration of the paraspinal muscles. Statically significant post-operative MFI change was only noted in erector spinae muscle at caudal adjacent level and L2-S1 mean global level. COS produces a greater decompressive effect than MIS.

101 Lumbar Fusion Versus Laminectomy for Spondylolisthesis: Lessons Learned from the AANS/CNS Spine Section Study Group's Analysis of the N2QOD Registry

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 219-220
Author(s):  
Erica Fay Bisson ◽  
Mohamad Bydon ◽  
Michael S Virk ◽  
Steven D Glassman ◽  
Kevin T Foley ◽  
...  
Keyword(s):  
Back Pain ◽  
Lumbar Fusion ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Absolute Difference ◽  
Section Study ◽  
Pain Scores ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Level Fusion

Abstract INTRODUCTION The AANS/CNS Spine Section Study Group analyzed 12-month outcomes data from for patients undergoing either laminectomy with fusion or laminectomy alone for grade 1 degenerative spondylolisthesis at ten sites. METHODS 475 patients undergoing elective spine surgery for degenerative grade 1 lumbar spondylolisthesis were identified by retrospective analysis of prospectively collected data from the QOD spine registry. Patients with more than one level fusion were excluded (n = 121) leaving a 354 patient cohort. Patients undergoing 1 level fusion with 1–3 levels of laminectomy (n = 274) were compared to those undergoing 1–3 levels of laminectomy alone (n = 80). RESULTS >For patients presenting with Grade1 spondylolisthesis, 23% (80/354) underwent laminectomy alone while 77% (274/354) underwent 1 level fusion with laminectomy. The percentage of cases returning to the OR within one year was similar for the laminectomy (6.2%) versus the fusion group (6.9%). At baseline, the fusion group had higher NRS back pain (7.0 ± 2.4 vs 5.94 ± 3.0, P< 0.01) and ODI (46.2 ± 15.3 vs 36.8 ± 16.3, P< 0.001) scores than the laminectomy alone group, however, NRS leg pain scores were equivalent. When comparing absolute difference in outcomes at 12-months to baseline, NRS back pain (4.1 ± 2.9 vs 3.1 ± 3.5, P = 0.05) and ODI (25.7 ± 16 vs 19.0 ± 17, P< 0.01) scores improved to a greater extent in the fusion group compared to laminectomy alone group whereas NRS leg pain scores improved equally. Patient satisfaction scores were equivalent for both surgical groups. CONCLUSION The data indicate that fusion with laminectomy for grade 1 degenerative lumbar spondylolisthesis is associated with low readmission and re-operation rates. Patients in the laminectomy with fusion group report more baseline back pain (NRS-back pain) and disability (ODI). Patients undergoing fusion with laminectomy report greater improvement in back pain and less disability at 12-months as compared to those in the lam group, while both groups had equivalent improvement in leg pain.

Dynamic Degenerative Lumbar Spondylolisthesis: Diagnosis With Axial Loaded Magnetic Resonance Imaging

Spine ◽  
2006 ◽  
Vol 31 (10) ◽  
pp. E298-E301 ◽  
Author(s):  
Prakash Jayakumar ◽  
Colin Nnadi ◽  
Asif Saifuddin ◽  
Emer MacSweeney ◽  
Adrian Casey
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

Degenerative lumbar spondylolisthesis with an intact neural arch (pseudospondylolisthesis)

1976 ◽  
Vol 44 (2) ◽  
pp. 139-147 ◽  
Author(s):  
Joseph A. Epstein ◽  
Bernard S. Epstein ◽  
Leroy S. Lavine ◽  
Robert Carras ◽  
Alan D. Rosenthal
Keyword(s):  
Degenerative Spondylolisthesis ◽  
Cauda Equina ◽  
Herniated Disc ◽  
Neurogenic Claudication ◽  
Neural Arch ◽  
Content Type ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Anterior Tibial ◽  
Straight Leg Raising ◽  
Lumbar Spondylolisthesis

✓ Twenty patients treated for degenerative spondylolisthesis with an intact neural arch principally at the L4–5 interspace had neural compression caused by dislocation of the vertebral bodies and intrusions of lamina and enlarged, arthrotic facets into a stenotic spinal canal. The resulting “pincer” effect caused complete or partial block demonstrable on myelography, with nerve root and cauda equina compression. Most of the patients were women aged 45 to 84 years. Seven had neurogenic claudication. The majority had unrestricted straight-leg raising, and no signs of acute neural entrapment were seen as in patients with a herniated disc. Absent ankle reflexes, and weakness and atrophy of the anterior tibial muscle group were common, while sensation was relatively undisturbed. Treatment consisted of liberal laminar decompression including foraminotomy and medial or total facetectomy. Good-to-excellent results were obtained, and no patient was made worse by the procedure.

scholarly journals Defining the minimum clinically important difference for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database

2018 ◽  
Vol 44 (1) ◽  
pp. E2 ◽  
Author(s):  
Anthony L. Asher ◽  
Panagiotis Kerezoudis ◽  
Praveen V. Mummaneni ◽  
Erica F. Bisson ◽  
Steven D. Glassman ◽  
...  
Keyword(s):  
Rating Scale ◽  
Degenerative Spondylolisthesis ◽  
Minimum Clinically Important Difference ◽  
Leg Pain ◽  
Satisfaction Scale ◽  
Quality Outcomes ◽  
Clinically Important Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Patient Reported ◽  
Lumbar Spondylolisthesis

OBJECTIVEPatient-reported outcomes (PROs) play a pivotal role in defining the value of surgical interventions for spinal disease. The concept of minimum clinically important difference (MCID) is considered the new standard for determining the effectiveness of a given treatment and describing patient satisfaction in response to that treatment. The purpose of this study was to determine the MCID associated with surgical treatment for degenerative lumbar spondylolisthesis.METHODSThe authors queried the Quality Outcomes Database registry from July 2014 through December 2015 for patients who underwent posterior lumbar surgery for grade I degenerative spondylolisthesis. Recorded PROs included scores on the Oswestry Disability Index (ODI), EQ-5D, and numeric rating scale (NRS) for leg pain (NRS-LP) and back pain (NRS-BP). Anchor-based (using the North American Spine Society satisfaction scale) and distribution-based (half a standard deviation, small Cohen’s effect size, standard error of measurement, and minimum detectable change [MDC]) methods were used to calculate the MCID for each PRO.RESULTSA total of 441 patients (80 who underwent laminectomies alone and 361 who underwent fusion procedures) from 11 participating sites were included in the analysis. The changes in functional outcome scores between baseline and the 1-year postoperative evaluation were as follows: 23.5 ± 17.4 points for ODI, 0.24 ± 0.23 for EQ-5D, 4.1 ± 3.5 for NRS-LP, and 3.7 ± 3.2 for NRS-BP. The different calculation methods generated a range of MCID values for each PRO: 3.3–26.5 points for ODI, 0.04–0.3 points for EQ-5D, 0.6–4.5 points for NRS-LP, and 0.5–4.2 points for NRS-BP. The MDC approach appeared to be the most appropriate for calculating MCID because it provided a threshold greater than the measurement error and was closest to the average change difference between the satisfied and not-satisfied patients. On subgroup analysis, the MCID thresholds for laminectomy-alone patients were comparable to those for the patients who underwent arthrodesis as well as for the entire cohort.CONCLUSIONSThe MCID for PROs was highly variable depending on the calculation technique. The MDC seems to be a statistically and clinically sound method for defining the appropriate MCID value for patients with grade I degenerative lumbar spondylolisthesis. Based on this method, the MCID values are 14.3 points for ODI, 0.2 points for EQ-5D, 1.7 points for NRS-LP, and 1.6 points for NRS-BP.

scholarly journals Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis

2018 ◽  
Vol 12 (2) ◽  
pp. 356-364 ◽  
Author(s):  
Yutaka Kono ◽  
Hogaku Gen ◽  
Yoshio Sakuma ◽  
Yasuhide Koshika
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Hospitalization Period ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Indirect Decompression ◽  
Lumbar Spondylolisthesis ◽  
Lateral Interbody ◽  
Mini Open

<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis.</p></sec><sec><title>Overview of Literature</title><p>There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF.</p></sec><sec><title>Methods</title><p>Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery.</p></sec><sec><title>Results</title><p>There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss (<italic>p</italic>&lt;0.001). Serious complications were not observed in either group. In clinical assessment, no significant differences were observed between the groups with regard to the JOABPEQ results. The change in DH at 12 months after surgery increased significantly in the X group (<italic>p</italic>&lt;0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group (<italic>p</italic>&lt;0.001).</p></sec><sec><title>Conclusions</title><p>Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater correction of DH were observed in XLIF.</p></sec>

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