Clinical Correlation between Muscle Damage and Oswestry Disability Index Score after Open Lumbar Surgery: Does Open Surgery Reduces Functional Ability?

Tandon, Rushama; Kiyawat, Vivek; Kumar, Neeraj

doi:10.4184/asj.2018.12.3.518

Cited by 12 publications

(9 citation statements)

References 25 publications

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“…23,24 A recent study reported significant decrease of 1.1% to 4.2% in thigh muscle volume and 1.0% to 3.4% in quadriceps within 5 days after surgery. 25 Tandon et al 26 showed significant damage to the lumbar paraspinal muscles (a reduction in the CSA and denervation) after lumbar fusion surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of Protein Supplement on Paraspinal Muscles in Spine Fusion Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

et al. 2021

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Background: Dysfunction and weakness due to atrophy of the paraspinal muscles is a major issue after posterior spinal fusion (PSF) surgery, resulting in pain and disability. Considering the role of protein in muscle regeneration, it seems that protein supplements after surgery may prevent muscle atrophy. To date, to our knowledge, no intervention study has investigated the effect of protein supplementation on the volume of paraspinal muscles, pain, or disability after PSF.Methods: In this randomized, double-blind, placebo-controlled clinical trial, patients were randomly assigned to a control (placebo þ diet with 1.2 g/kg body weight of protein, n ¼ 40) or a protein supplementation (36 g/day þ a diet with 1.2 g/kg body weight of protein, n ¼ 40) group, which received intervention from 48 hours before to 1 month after surgery. The cross-sectional area (CSA) of the paraspinal muscles was measured by thin-slice computed tomography, and pain and disability were assessed using the visual analog scale and Oswestry Disability Index.Results: After 4 weeks of protein supplementation, the CSAs of multifidus and psoas muscles on both sides were significantly higher in the supplementation group than the placebo group (P ,.001). Less atrophy was seen in the right erector spinae and quadratus lumborum muscles in the group receiving protein supplements than the placebo group (P , .001). In addition, protein supplementation was significantly negatively correlated with both pain (P , .001) and disability (P , .001).Conclusions: In conclusion, we demonstrated that 36 g/day protein supplementation significantly increased the CSA of muscles and reduced the atrophy, pain, and disability after PSF surgery.

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Section: Discussionmentioning

confidence: 99%

Effect of Protein Supplement on Paraspinal Muscles in Spine Fusion Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

et al. 2021

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“…For evaluating soft tissue trauma post-operatively, most studies used imaging studies (CT or MRI) to evaluate the morphology of the para-spinal muscle, and revealed that MIS can decrease post-operative muscle atrophy as compared with COS. 18 - 20 However, Urrutia et al suggested that single-level fat signal fractions and cross-sectional area are not representative of the whole lumbar spine. 21 Surface EMG is an objective and effective tool for evaluating back muscle function.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of Lumbar Muscle Performance Between Minimally-Invasive and Open Lumbar Fusion Surgery at 1-Year Follow-Up

Cheng

Chen

et al. 2020

Global Spine Journal

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Study Design: Prospective study. Objective: Minimally-invasive lumbar fusion surgery (MIS) is a viable alternative to conventional open surgery (COS) for spinal disorders. Although MIS seems to be associated with less para-spinal muscle trauma, the actual back muscle performance after MIS and COS remain controversial. This study investigated post-operative para-spinal muscle performance, and the correlation between muscle dysfunction and clinical outcome. Methods: In this prospective, non-randomized control study, 50 patients were enrolled and split into 2 groups: COS and MIS. We established a biomechanical model of the para-spinal muscle in the lumbar spine using electromyography (EMG) and specific muscle function tests. Functional outcomes were also reviewed and analyzed. All patients underwent EMG pre-operatively, and at 3 months and 1 year post-operatively. The para-spinal muscle performance was investigated by comparing the back muscle co-contraction ratio and the load transmission zone to the pre-operative data. Results: Twenty-one patients in the COS group and 25 in the MIS group completed the study. Both groups showed a significant improved functional score. The abdominal and back muscle strengths were decreased post-operatively, and were then increased at 12 months post-operatively in both groups. During the perturbed balance task and static task, the MIS group exhibited a trend of recovery in comparison with the COS group. But, the back muscle performance at 12 months was poorer than the pre-op performance in both groups. Conclusions: There was no significant difference in clinical outcome and para-spinal muscle performance between groups. In both methods, the global muscle function had declined post-operatively.

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“…During the posterior lumbar surgery exposure process, it is inevitable that paravertebral muscles will be stripped and damaged [ 34 ]. Postoperative lumbar MRI shows that paravertebral muscles have different degrees of injury [ 35 ], accompanied by low back pain and dysfunction [ 36 ]. However, minimally invasive surgical methods can significantly reduce paravertebral muscle atrophy.…”

Section: Factors Of Multifidus Injurymentioning

confidence: 99%

Research Progress on the Mechanism of Lumbarmultifidus Injury and Degeneration

Wang

Jia

et al. 2021

Oxidative Medicine and Cellular Longevity

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This review summarizes recent research progress in the clinical features, image manifestations, and pathological mechanism of multifidus injury. After a brief introduction to the fiber classification, innervation, blood supply, and multifidus function, some factors of multifidus injury, consisting of denervation, intraoperative incision selection and traction, and lumbar degenerative disease are overviewed. In addition, the clinical index of multifidus injury including myoglobin, creatine kinase, IL-6, C-reactive protein, the cross-sectional area of multifidus, the degree of fat infiltration, and intraoperative biopsy are summarized. Furthermore, we recommend that patients with chronic low back pain should take the long-term exercise of lumbodorsal muscles. Finally, some remaining issues, including external fixation and the imaging quantitative evaluation criteria of multifidus, need to be further explored in the future.

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Clinical Correlation between Muscle Damage and Oswestry Disability Index Score after Open Lumbar Surgery: Does Open Surgery Reduces Functional Ability?

Cited by 12 publications

References 25 publications

Effect of Protein Supplement on Paraspinal Muscles in Spine Fusion Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

Effect of Protein Supplement on Paraspinal Muscles in Spine Fusion Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

Comparisons of Lumbar Muscle Performance Between Minimally-Invasive and Open Lumbar Fusion Surgery at 1-Year Follow-Up

Research Progress on the Mechanism of Lumbarmultifidus Injury and Degeneration

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