Effect and Possible Mechanism of Muscle-Splitting Approach on Multifidus Muscle Injury and Atrophy After Posterior Lumbar Spine Surgery

Hu, Zhijun; Fang, Xiangqian; Zhou, Zhong Kai; Wang, Jiying; Zhao, Fengdong; Fan, Shunwu

doi:10.2106/jbjs.l.01607

Cited by 84 publications

(74 citation statements)

References 27 publications

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“…At present, the commonly used surgical procedure is open lumbar posterior nerve root decompression and exploration 2. However, the traditional open surgery is associated with large incision, requiring extensive stripping of the paravertebral soft tissues, heavy trauma, and a large amount of blood loss, which usually leads to denervation of muscle and atrophy,5–7 and in addition, the patients suffer from long-term postoperative lumbodorsal muscle pain. These postoperative complications seriously affect the clinical recovery and patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the clinical effects of transforaminal endoscopic discectomy on lumbar disk herniation combined with common peroneal nerve paralysis: a 2-year follow-up retrospective study on 32 patients

Wang

Zhang

et al. 2017

JPR

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BackgroundVery few studies have discussed transforaminal endoscopic discectomy (TED) in the treatment of common peroneal nerve paralysis induced by lumbar disk herniation (LDH). This study aimed to evaluate the efficacy of TED in the treatment of LDH combined with common peroneal nerve paralysis.Materials and methodsThe clinical and follow-up data of 32 patients with common peroneal nerve paralysis induced by LDH undergoing TED from March 2011 to April 2014 were retrospectively analyzed in this study. Follow-up was conducted immediately after the surgery, as well as 3, 12, and 24 months postoperatively. The parameters (including muscle strength recovery of the anterior tibial muscle, leg pain visual analog scale score, neurological function Japanese Orthopaedic Association [JOA] score, MacNab scores in the last follow-up, and the intraoperative and postoperative complications) were recorded.ResultsThree patients (9.4%) had the anterior tibial muscle strength recovered to ≥ grade 4 immediately after the surgery. The anterior tibial muscle strength of patients recovered to basically stable form in the 6-month postoperative follow-up and that in the last follow-up were as follows: one case of grade 1, one case of grade 2, 28 cases of grade 4, and two cases of grade 5. The visual analog scale scores of leg pain were significantly reduced immediately after the surgery and also on 3, 12, and 24 months compared with preoperative period (all P<0.05). The postoperative JOA scores in the last follow-up were significantly higher than the preoperative JOA scores (P<0.05), and there were nine excellent cases (28.2%), 21 good cases (65.6%), one fair case (3.1%) and one poor case (3.1%) in the last follow-up, with an overall excellent and good rate of 93.8%.ConclusionTED, which can offer sufficient decompression of the nerve root, has excellent overall clinical effects in treating common peroneal nerve paralysis induced by LDH.

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Section: Introductionmentioning

confidence: 99%

Analysis of the clinical effects of transforaminal endoscopic discectomy on lumbar disk herniation combined with common peroneal nerve paralysis: a 2-year follow-up retrospective study on 32 patients

Wang

Zhang

et al. 2017

JPR

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“…Postoperative residual lumbago and backache are the disadvantages of traditional PLIF surgery 2. Our data showed that MIS-TLIF reduced the back pain VAS scores 3 months after surgery in comparison with the PLIF.…”

Section: Discussionmentioning

confidence: 53%

“…However, the traditional PLIF requires large incision, extensive dissection of paraspinal soft tissue trauma and blood loss, which inevitably contributes to muscle denervation and atrophy 1. Moreover, because of the removal of the bilateral vertebral plate, spinous process and ligament, the lumbar spine rear structural damage is large, and this surgery inevitably leads to postoperative adhesions, dural nerve roots and long-term low back muscle pain 2. All these later complications seriously affect the clinical efficacy and decrease the patients’ quality of life.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes between minimally invasive transforaminal lumbar interbody fusion and traditional posterior lumbar intervertebral fusion in obese patients with lumbar disk prolapse

Wang¹,

An²,

Sun³

et al. 2017

TCRM

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ObjectiveThe aim of this study was to compare the curative effect between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and the posterior lumbar interbody fusion (PLIF) in obese patients with lumbar disk prolapse.Patients and methodsIn this study, 72 patients who underwent lumbar disk prolapse therapy in the Third Hospital of Hebei Medical University between March 2011 and 2015 were retrospectively analyzed and were divided into two groups, MIS-TLIF group (n=35) and PLIF group (n=37), according to different surgical procedures. Several clinical parameters were compared between these two groups.ResultsCompared with PLIF, MIS-TLIF was associated with longer operative time, less blood loss, less postoperative drainage and shorter postoperative time in bed; moreover, patients in the MIS-TLIF group had lower levels of serum creatine kinase on 1, 3 and 5 postoperative days. At the 3- and 6-month follow-up, Visual Analog Scale (VAS) scores of low back pain of patients in the MIS-TLIF group were significantly reduced and Japanese Orthopaedic Association (JOA) scores were increased, whereas the Oswestry Disability Index (ODI) showed no significant difference between the two groups.ConclusionObese patients can achieve good efficacy with MIS-TLIF or PLIF treatment, but MIS-TLIF surgery showed longer operative time, fewer traumas and bleeding volume, less incidence of short-term pain, low complication rate and faster postoperative recovery.

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“…There are many muscles at the posterior the lumbar spine that support our body, the back muscle injury is one of the main problems of traditional open posterior lumbar surgery (26,27). Hu et al (13) reported that the traditional powerful muscle retraction will not only cause multifidus injury, but also cause long-term multifidus atrophy after posterior lumbar surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of single segmental lumbar spondylolisthesis: minimum two-year follow up

Wu¹,

Hu²,

Li³

et al. 2018

Ann. Transl. Med.

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Effect and Possible Mechanism of Muscle-Splitting Approach on Multifidus Muscle Injury and Atrophy After Posterior Lumbar Spine Surgery

Abstract: This study provides a basis for the prevention of multifidus muscle injury and atrophy after posterior lumbar surgery.

Cited by 84 publications

References 27 publications

Analysis of the clinical effects of transforaminal endoscopic discectomy on lumbar disk herniation combined with common peroneal nerve paralysis: a 2-year follow-up retrospective study on 32 patients

Analysis of the clinical effects of transforaminal endoscopic discectomy on lumbar disk herniation combined with common peroneal nerve paralysis: a 2-year follow-up retrospective study on 32 patients

Comparison of outcomes between minimally invasive transforaminal lumbar interbody fusion and traditional posterior lumbar intervertebral fusion in obese patients with lumbar disk prolapse

Comparison of minimally invasive and open transforaminal lumbar interbody fusion in the treatment of single segmental lumbar spondylolisthesis: minimum two-year follow up

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