Effects of Muscle Dysfunction on Lumbar Spine Mechanics

Kong, Wayne; Goel, Vijay K.; Gilbertson, Lars G.; Weinstein, James Neil

doi:10.1097/00007632-199610010-00004

Cited by 51 publications

(14 citation statements)

References 37 publications

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“…In contrast to the CBT approach, at a mean follow-up of 12 months after surgery, there was a reduction in the cross-sectional area of the paraspinal muscles at the surgical site for the open technique. Anatomic damage to the paraspinal muscles has been associated with the occurrence of back muscle dysfunction after surgery [ 8 , 9 ]. Therefore minimizing the iatrogenic injury to the muscles is significant.…”

Section: Discussionmentioning

confidence: 99%

Cortical Bone Trajectory Screws in Posterior Lumbar Interbody Fusion: Minimally Invasive Surgery for Maximal Muscle Sparing—A Prospective Comparative Study with the Traditional Open Technique

Marengo

Ajello

Pecoraro

et al. 2018

BioMed Research International

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Introduction A prospective comparative study between classical posterior interbody fusion with peduncular screws and the new technique with divergent cortical screws was conducted. Material and Methods Only patients with monosegmental degenerative disease were recruited into this study. We analyzed a cohort of 40 patients treated from January 2015 to March 2016 divided into 2 groups (20 patients went to traditional open surgery and 20 patients under mini-invasive strategy). Primary endpoints of this study are fusion rate and muscular damage; secondary endpoints analyzed were three different clinical scores (ODI, VAS, and EQ) and the morbidity rate of both techniques. Results There was no significant difference in fusion rate between the two techniques. In addition, a significant difference in muscular damage was found according to the MRI evaluation. Clinical outcomes, based on pain intensity, Oswestry Disability Index status, and Euroquality-5D score, were found to be also statistically different, even one year after surgery. This study also demonstrated a correlation between patients' muscular damage and their clinical outcome. Conclusions Cortical bone trajectory screws would provide similar outcomes compared to pedicle screws in posterior lumbar interbody fusion at one year after surgery, and this technique represents a reasonable alternative to pedicle screws.

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Section: Discussionmentioning

confidence: 99%

Cortical Bone Trajectory Screws in Posterior Lumbar Interbody Fusion: Minimally Invasive Surgery for Maximal Muscle Sparing—A Prospective Comparative Study with the Traditional Open Technique

Marengo

Ajello

Pecoraro

et al. 2018

BioMed Research International

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“…Kong et al conducted an FE study in which muscle dysfunction due to quasistatic backlifting conditions was simulated and found that muscle dysfunction destabilized the spine, reduced the role of facet joints in transmitting load, and shifted loads to the discs and ligaments [21]. …”

Section: Biomechanics Of Disc Degenerationmentioning

confidence: 99%

Biomechanics of Disc Degeneration

Palepu

Kodigudla²,

Goel³

2012

Advances in Orthopedics

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Disc degeneration and associated disorders are among the most debated topics in the orthopedic literature over the past few decades. These may be attributed to interrelated mechanical, biochemical, and environmental factors. The treatment options vary from conservative approaches to surgery, depending on the severity of degeneration and response to conservative therapies. Spinal fusion is considered to be the “gold standard” in surgical methods till date. However, the association of adjacent level degeneration has led to the evolution of motion preservation technologies like spinal arthroplasty and posterior dynamic stabilization systems. These new technologies are aimed to address pain and preserve motion while maintaining a proper load sharing among various spinal elements. This paper provides an elaborative biomechanical review of the technologies aimed to address the disc degeneration and reiterates the point that biomechanical efficacy followed by long-term clinical success will allow these nonfusion technologies as alternatives to fusion, at least in certain patient population.

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“…Paraspinal muscles play a role in maintaining the normal functions of the lumbar spine [1]. It is believed that low back pain [2-4], lumbosacral radiculopathy [5-8], and iatrogenic injury of medial branch of dorsal ramus after spinal surgery [9,10] leads to atrophy and fatty infiltrations of paraspinal muscles.…”

Section: Introductionmentioning

confidence: 99%

The Location of Multifidus Atrophy in Patients With a Single Level, Unilateral Lumbar Radiculopathy

Kang

Kim²,

Kim

et al. 2013

Ann Rehabil Med

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ObjectiveTo identify the correlations between the location of multifidus atrophy and the level of lumbar radiculopathy.MethodsThirty-seven patients who had unilateral L4 or L5 radiculopathy were divided into 2 groups; the L4 radiculopathy (L4 RAD) group and the L5 radiculopathy (L5 RAD) group. Bilateral lumbar multifidus muscles at the mid-spinous process level of L4 vertebra (L4 MSP), the mid-spinous process level of L5 vertebra (L5 MSP), and the mid-sacral crest level of S1 vertebra (S1 MSC) were detected in T1 axial magnetic resonance imaging. The total muscle cross-sectional area of multifidus muscles (TMCSA) and the pure muscle cross-sectional area of multifidus muscles (PMCSA) were measured by a computerized analysis program, and the ratio of PMCSA to TMCSA (PMCSA/TMCSA) was calculated.ResultsThere were no significant differences in TMCSA between the involved and the uninvolved sides in both groups. PMCSA was only significantly smaller at the S1 MSC on the involved side as compared with the uninvolved side in the L5 RAD group. The ratio of PMCSA to TMCSA was the lowest at the L5 MSP on the involved side in the L4 RAD group and at the S1 MSC on the involved side in the L5 RAD group.ConclusionOur findings suggest that the most severe atrophy of multifidus muscle may occur at the mid-spinous process or mid-sacral crest level of the vertebra which is one level below the segmental number of the involved nerve root in patients with a single-level, unilateral lumbar radiculopathy.

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Effects of Muscle Dysfunction on Lumbar Spine Mechanics

Abstract: Muscle dysfunction disturbs the normal functioning of other spinal components and may cause spinal disorders.

Cited by 51 publications

References 37 publications

Cortical Bone Trajectory Screws in Posterior Lumbar Interbody Fusion: Minimally Invasive Surgery for Maximal Muscle Sparing—A Prospective Comparative Study with the Traditional Open Technique

Cortical Bone Trajectory Screws in Posterior Lumbar Interbody Fusion: Minimally Invasive Surgery for Maximal Muscle Sparing—A Prospective Comparative Study with the Traditional Open Technique

Biomechanics of Disc Degeneration

The Location of Multifidus Atrophy in Patients With a Single Level, Unilateral Lumbar Radiculopathy

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