Radiological Assessment of Damage to the Iliopsoas Muscle by the Oblique Lateral Interbody Fusion Approach

Inoue, Masahiro; Orita, Sumihisa; Inage, Kazuhide; Fujimoto, Kazuki; Kanamoto, Hirohito; Abe, Koki; Kinoshita, Hideyuki; Norimoto, Masaki; Umimura, Tomotaka; Sato, Takashi; Sato, Masashi; Suzuki, Masahiro; Enomoto, Kazuyuki; Eguchi, Yawara; Aoki, Yasuchika; Akazawa, Tsutomu; Ohtori, Seiji

doi:10.22603/ssrr.2019-0024

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…Analogously to MR images, the Goutallier classification can be used in CT images. The cross-sectional area of the muscle can be determined by contouring the muscle and calculating the total area using different software [Advanced Workstation (GE, USA) in Waschke et al ( 19 ), image J ( 69 ) in Takada et al ( 32 ) or AZE Virtual Place Raijin (Canon Inc., Tokyo) in Inoue et al ( 39 )]. Additionally, CT can be used to quantify the surgical exposure of different approaches.…”

Section: Resultsmentioning

confidence: 99%

“…The development of the cross-sectional area of a muscle and the progression of the muscle-to-fat ratio can also be depicted in computed tomography scans (19,32,39). The muscle-tofat ratio can be determined by distinguishing muscular from fatty tissue according to their Hounsfield units [e.g., (19) 46), K-wires were placed on the outer edges of the surgically exposed capitellum using different surgical approaches.…”

Section: Ctmentioning

confidence: 99%

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Overview of Methods to Quantify Invasiveness of Surgical Approaches in Orthopedic Surgery—A Scoping Review

et al. 2022

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BackgroundThere is a trend toward minimally invasive and more automated procedures in orthopedic surgery. An important aspect in the further development of these techniques is the quantitative assessment of the surgical approach. The aim of this scoping review is to deliver a structured overview on the currently used methods for quantitative analysis of a surgical approaches' invasiveness in orthopedic procedures. The compiled metrics presented in the herein study can serve as the basis for digitization of surgery and advanced computational methods that focus on optimizing surgical procedures.MethodsWe performed a blinded literature search in November 2020. In-vivo and ex-vivo studies that quantitatively assess the invasiveness of the surgical approach were included with a special focus on radiological methods. We excluded studies using exclusively one or multiple of the following parameters: risk of reoperation, risk of dislocation, risk of infection, risk of patient-reported nerve injury, rate of thromboembolic event, function, length of stay, blood loss, pain, operation time.ResultsThe final selection included 51 articles. In the included papers, approaches to 8 different anatomical structures were investigated, the majority of which examined procedures of the hip (57%) and the spine (29%). The different modalities to measure the invasiveness were categorized into three major groups “biological” (23 papers), “radiological” (25), “measured in-situ” (14) and their use “in-vivo” or “ex-vivo” was analyzed. Additionally, we explain the basic principles of each modality and match it to the anatomical structures it has been used on.DiscussionAn ideal metric used to quantify the invasiveness of a surgical approach should be accurate, cost-effective, non-invasive, comprehensive and integratable into the clinical workflow. We find that the radiological methods best meet such criteria. However, radiological metrics can be more prone to confounders such as coexisting pathologies than in-situ measurements but are non-invasive and possible to perform in-vivo. Additionally, radiological metrics require substantial expertise and are not cost-effective. Owed to their high accuracy and low invasiveness, radiological methods are, in our opinion, the best suited for computational applications optimizing surgical procedures. The key to quantify a surgical approach's invasiveness lies in the integration of multiple metrics.

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Section: Resultsmentioning

confidence: 99%

Section: Ctmentioning

confidence: 99%

Overview of Methods to Quantify Invasiveness of Surgical Approaches in Orthopedic Surgery—A Scoping Review

et al. 2022

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“…(3) Due to policy changes, this study did not analyze the impact of nursing model combined with ERAS concept on patients' clinical costs. (4) The survey of patient satisfaction did not indicate an appropriate rating scale, thus, it was impossible to determine in more detailed the specific aspects of the improvement of patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with the traditional posterior lumbar surgery, OLIF has less interference with the posterior muscles and ligaments, less blood loss, and faster postoperative recovery. It can effectively reduce the incidence of pain syndrome after lumbar surgery ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

A new nursing pattern based on ERAS concept for patients with lumbar degenerative diseases treated with OLIF surgery: A retrospective study

Yang

et al. 2023

Front. Surg.

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ObjectiveThe purpose of this study was to introduce enhanced recovery after surgery (ERAS) concept into patients with lumbar degenerative diseases who were treated with oblique lumbar interbody fusion (OLIF), and to assess whether it could increase clinical efficacy, reduce perioperative complications, shorten length of hospital stay (LHS), decrease readmission rate, and improve patient satisfaction.MethodsThe study included patients with lumbar degenerative diseases (LDDs) who underwent OLIF between July 2017 and October 2018 (non-ERAS group), and between November 2018 and July 2020 (ERAS group). The two groups were compared according to the demographic and clinical characteristics.ResultsThere was no significant difference in descriptive characteristics and concomitant diseases between the two groups. The preoperative Oswestry disability index (ODI) score (P = 0.191), lumbar visual analogue scale (VAS) score (P = 0.470), and leg VAS score (P = 0.657) did not significantly different. Most of the ERAS measures were also well implemented after surgery, except for early delivery (74.2%), early catheter removal (63.9%), and multimodal analgesia (80.6%). The LHS in the ERAS group was significantly shorter than that in the non-ERAS group (P = 0.004). Besides, Hamilton Anxiety Rating Scale (HAMA) score at 3 days after surgery showed a significant difference between the two groups (P = 0.019). The patient satisfaction in ERAS group was significantly higher than that in the non-ERAS group (P = 0.001).ConclusionThe new nursing pattern combined with ERAS in patients with LDDs who underwent OLIF did not improve the short-term prognosis of surgery, while it could effectively reduce postoperative complications, shorten the LHS, and improve patient satisfaction, and did not lead to additional adverse events.

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“…Future areas for investigation could include directly comparing the predictive value of psoas and multifidus muscle quality on patient outcomes in cohorts undergoing LLIF or lumbar fusion via a posterior approach. Additionally, while a study by Inoue et al evaluated postoperative changes to the psoas following anterior-to-psoas oblique lateral interbody fusion (OLIF), finding only transient swelling but no atrophic changes up to 1-year, 44 no studies have investigated the effect of the transpsoas approach on psoas architecture. Therefore, future investigations could also evaluate the longitudinal change in psoas and paraspinal muscle quality from baseline following LLIF.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Multifidus Muscle Quality is Associated With Patient Reported Outcomes After Lateral Lumbar Interbody Fusion

Zavras

Sullivan

Federico

et al. 2022

Global Spine Journal

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Study Design Retrospective cohort Objective Lateral lumbar interbody fusion (LLIF) commonly involves a transpsoas approach. Despite the association between LLIF, postoperative iliopsoas weakness, and iatrogenic neuropraxia, no study has yet examined the effect of psoas or multifidus muscle quality on patient-reported outcomes (PROs). Methods This study retrospectively reviewed patients who underwent LLIF with 1-year minimum follow-up. Psoas and multifidus muscle qualities were graded on preoperative magnetic resonance imaging using two validated classification systems for muscle atrophy. Average muscle quality was calculated as the mean score from all levels (L1-2 through L5-S1). Univariate and multivariate statistics were utilized to investigate the relationship between psoas/multifidus muscle quality and preoperative, 6-weeks postoperative, and final postoperative PROs. Results 74 patients (110 levels) with a mean follow-up of 18.71 ± 8.02 months were included for analysis. Greater multifidus atrophy was associated with less improvement on ODI, SF12, and VR12 ( P < .05) on univariate analysis. On multivariate analysis, worse multifidus atrophy predicted less improvement on SF12 and VR12 ( P < .05). Conclusion Despite the direct manipulation of the psoas muscle inherent to LLIF, preoperative psoas muscle quality did not affect postoperative outcomes. Rather, the extent of preoperative multifidus fatty infiltration and atrophy was more likely to predict postoperative pain and disability. These findings suggest that multifidus atrophy may be more pertinent than psoas atrophy in its association with patient-reported outcome measures after LLIF.

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Radiological Assessment of Damage to the Iliopsoas Muscle by the Oblique Lateral Interbody Fusion Approach

Cited by 7 publications

References 20 publications

Overview of Methods to Quantify Invasiveness of Surgical Approaches in Orthopedic Surgery—A Scoping Review

Overview of Methods to Quantify Invasiveness of Surgical Approaches in Orthopedic Surgery—A Scoping Review

A new nursing pattern based on ERAS concept for patients with lumbar degenerative diseases treated with OLIF surgery: A retrospective study

Preoperative Multifidus Muscle Quality is Associated With Patient Reported Outcomes After Lateral Lumbar Interbody Fusion

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