Local Denervation Atrophy of Paraspinal Muscles in Postoperative Failed Back Syndrome

Sihvonen, T; Herno, Arto; Paljärvi, Leo; Airaksinen, Olavi; Partanen, Juhani; Tapaninaho, A.

doi:10.1097/00007632-199304000-00009

Cited by 560 publications

(343 citation statements)

References 0 publications

Supporting

Mentioning

320

Contrasting

Unclassified

Order By: Relevance

“…Extensive paraspinal muscle detachment from the midline osseous structures can cause weakness secondary to muscle denervation [9,10]. In addition, removal of the midline structures (i.e.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis

et al. 2015

View full text Add to dashboard Cite

Purpose To compare the effectiveness of techniques of posterior decompression that limit the extent of bony decompression or to avoid removal of posterior midline structures of the lumbar spine versus conventional facetpreserving laminectomy for the treatment of patients with degenerative lumbar stenosis. Methods A comprehensive electronic search of the Cochrane Central Register of Controlled Trials, MED-LINE, EMBASE, Web of Science, and the clinical trials registries ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform was conducted for relevant literature up to June 2014. Results A total of four high-quality RCTs and six lowquality RCTs met the search criteria of this review. These studies included a total of 733 participants. Three different techniques that avoid removal of posterior midline structures are compared to conventional laminectomy; unilateral laminotomy for bilateral decompression, bilateral laminotomy and split-spinous process laminotomy. Evidence of low or very low quality suggests that different techniques of posterior decompression and conventional laminectomy have similar effects on functional disability and leg pain. Only perceived recovery at final follow-up was better in patients that underwent bilateral laminotomy compared with conventional laminectomy. Unilateral laminotomy for bilateral decompression and bilateral laminotomy resulted in numerically fewer cases of iatrogenic instability, although in both cases, the incidence of instability was low. The difference in severity of postoperative low back pain following bilateral laminotomy and split-spinous process laminotomy was significantly less, but was too small to be clinically important. We found no evidence to show that the incidence of complications, length of the procedure, length of hospital stay and postoperative walking distance differed between techniques of posterior decompression. Conclusion The evidence provided by this systematic review for the effects of unilateral laminotomy for bilateral decompression, bilateral laminotomy and split-spinous process laminotomy compared with conventional laminectomy on functional disability, perceived recovery and leg pain is of low or very low quality. Therefore, further research is necessary to establish whether these techniques provide a safe and effective alternative for conventional laminectomy. Proposed advantages of these techniques regarding the incidence of iatrogenic instability and postoperative back pain are plausible, but definitive conclusions are limited by poor methodology and poor reporting of outcome measures among included studies.

show abstract

“…Extensive paraspinal muscle detachment from the midline osseous structures can cause weakness secondary to muscle denervation [9,10]. In addition, removal of the midline structures (i.e.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Conventional, open dorsal instrumentation of the thoracolumbar spine requires extensive tissue dissection leading to denervation of paravertebral muscles as well as muscle and soft tissue ischemia potentially contributing to some cases of failed fracture stabilization [13]. Physical compression by soft tissue retractors during surgery induces time-dependent muscular histological damage via increased intramuscular pressure [14].…”

Section: Introductionmentioning

confidence: 99%

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

et al. 2013

View full text Add to dashboard Cite

Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58°, improved to 9.2°postoperatively and to 13.8°at the final follow-up. No cases of implant failure were reported at the final follow-up.Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities in managing burst thoracic and thoracolumbar fractures.

show abstract

“…With increasing age, there is a reduction in muscle volume [13,35]. Current evidence suggests that the paraspinal muscles are smaller in patients with chronic LBP [4,6,40,50] than in healthy individuals of similar age. Reduced size of multifidus has also been reported in acute LBP [16] and recent animal work has shown rapid changes in CSA in the multifidus muscle following discrete injury to an intervertebral disc [17].…”

Section: Introductionmentioning

confidence: 99%

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

View full text Add to dashboard Cite

The objectives of the study were to evaluate the association between lumbar paraspinal muscle density, evaluated on computed tomography (CT) and age, sex and BMI; and to evaluate the association of those changes with low back pain (LBP) and spinal degeneration features in a community-based sample. This study was an ancillary project to the Framingham Study. A sample of 3,529 participants aged 40-80 years had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this study. LBP in the last 12 months was evaluated using self-report questionnaire. Density (in Hounsfield units) of multifidus and erector spinae was evaluated on CT. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (FJOA), spondylolysis, spondylolisthesis and spinal stenosis were also evaluated. We used linear regression models to examine the association of paraspinal muscles density with age, sex, BMI, LBP, and spinal degeneration features. The results show that in our study, men have higher density of paraspinal muscles than women, younger individuals have higher density than older ones and individuals with lower weight have higher muscle density than overweight. No differences between individuals with and without LBP were found. Significant association was found between L4 multifidus/erector spinae density and FJOA at L4-L5; between multifidus at L4 and spondylolisthesis at L4-5; and between erector spinae at L4 and L5 with disc narrowing at L4-5 and L5-S1, respectively. We conclude that the paraspinal muscle density decreases with age, and increases BMI. It is associated with at some levels FJOA, spondylolisthesis and disc narrowing at the same level, but not associated with occurrence of LBP.

show abstract

Local Denervation Atrophy of Paraspinal Muscles in Postoperative Failed Back Syndrome

Cited by 560 publications

References 0 publications

Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis

Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Contact Info

Product

Resources

About