Assessment of Paraspinal Muscle Atrophy Percentage after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Using a Novel Contralateral Intact Muscle-Controlled Model

Abstract

Study DesignRetrospective comparative clinical study.PurposeThis study aimed to assess paraspinal muscle atrophy in patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation using a novel contralateral intact muscle-controlled model.Overview of LiteratureThe increased incidence of paravertebral lumbar muscle injuries after open techniques has raised the importance of implementing minimally invasive spine surgical techniques using tubular retractors and minimally invasive screw placement. The functional cross-sectional area (FCSA) represents the lean muscle mass; furthermore, FCSA is a useful marker of the contractile ability of a muscle following a spine surgery. However, the benefits of unilateral fixation and MI-TLIF on paraspinal muscles have not been defined.MethodsWe performed a retrospective imagenological review on eleven patients who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae were measured 1 year after surgery at adjacent levels and were compared to the contralateral intact muscles. Measurement differences between the surgical and nonsurgical sites were compared. The interobserver reliability was calculated using an intraclass correlation coefficient.ResultsThe mean FCSA at the surgical site was 20.97±5.07 cm2 at the superior level and 8.89±2.87 cm2 at the inferior level. The mean FCSA at the contralateral nonsurgical site was 20.15±5.95 cm2 at the superior level and 9.20±2.66 cm2 at the inferior level was. The superior and inferior FCSA measurements showed no significant difference between the surgical and nonsurgical sites (p=0.5, p=0.922, respectively).ConclusionsUsing a mini-open tubular approach through the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle damage at the superior and inferior adjacent levels.

Assessment of the association between paraspinal muscle degeneration and quality of life in patients with degenerative lumbar scoliosis

“…PVM degeneration is characterized by increased fat infiltration and decreased muscle volume (11). PVM degeneration is associated with various lumbar diseases and post-operative complications (12,13). It was reported that the degree of fat infiltration and atrophy of the multifidus is closely linked to the severity of lower back pain (LBP) (14)(15)(16).…”

Prospective Cohort Study with a 2-Year Follow-up of Clinical Results, Fusion Rate, and Muscle Bulk for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion

“…There was no significant change in the psoas muscle [ 26 ]. Ortega-Porcayo et al [ 27 ] found that when they performed minimally invasive transforaminal lumbar interbody fusion on one side with unilateral pedicle screw instrumentation, there was no significant difference between the surgical and the non-surgical sides. Our finding echoes the study by Ortega-Porcayo et al [ 27 ].…”

Degenerative characteristics of multifidus at different vertebral levels of scoliosis in patients with degenerative lumbar scoliosis and relationship of these degenerative characteristics with surface electromyography activity

“…The PVM play a crucial role in the stability and motor function of the lumbar spine and are associated with various lumbar spine diseases and postoperative complications [ 18 , 19 ]. The MF is sensitive to pathological changes and is the muscle that shows the most obvious and most common degeneration among the lumbar PVM [ 20 , 21 ].…”