Risk factors for screw loosening in patients with adult degenerative scoliosis: the importance of paraspinal muscle degeneration

Wang, Wei; Li, Weishi; Chen, Zhongqiang

doi:10.1186/s13018-021-02589-x

Cited by 16 publications

(23 citation statements)

References 32 publications

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“…Alterations in muscle structure and function, especially fatty infiltration and fibrosis, are clearly associated with spinal disorders [36]. An increasing number of studies have shown that in patients with DKS, the cross-sectional area of the lumbar erector spinae and psoas major is significantly thinner, and pathological assessment shows muscle atrophy, necrosis, and hyaline fibrosis, while muscle fat infiltration and inflammatory cell infiltration are more pronounced [37][38][39]. Therefore, we also performed pathological examination of the paraspinal muscle tissue of DKS mice by HE staining and Masson staining.…”

Section: Discussionmentioning

confidence: 99%

The Establishment of a Mouse Model for Degenerative Kyphoscoliosis Based on Senescence-Accelerated Mouse Prone 8

Tang

Kiram

et al. 2022

Oxidative Medicine and Cellular Longevity

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Objective. Degenerative kyphoscoliosis (DKS) is a complex spinal deformity associated with degeneration of bones, muscles, discs, and facet joints. The aim of this study was to establish an animal model of degenerative scoliosis that recapitulates key pathological features of DKS and to validate the degenerative changes in senescence-accelerated mouse prone 8 (SAMP8) mice. Methods. Thirty male mice were divided into 2 groups: 10 bipedal C57BL/6J mice were used as the control group, and 20 bipedal SAMP8 mice were used as the experimental group. Mice were bipedalized under general anesthesia. The incidence of scoliosis and bone quality was determined using radiographs and in vivo micro-CT images 4, 8, and 12 weeks after surgery, respectively. Histomorphological studies of muscle samples were performed after sacrifice at 12 weeks after surgery. Results. On the 12th week, the incidence rates of kyphosis in C57BL/6J and SAMP8 groups were 50% and 100%, respectively. Overall, the incidence and angle of kyphosis were significantly higher in the bipedal SAMP8 group compared to the C57BL/6J group (44.7°± 6.2° vs. 84.3°± 10.3°, P < 0.001 ). Based on 3D reconstruction of the entire spine, degeneration of the intervertebral disc was observed in bipedal SAMP8 mice, including the reduction of disc height and the formation of vertebral osteophytes. The bone volume ratio (BV/TV) was significantly suppressed in the bipedal SAMP8 group compared with the bipedal C57BL/6J group. In addition, HE staining and Mason staining of the paraspinal muscle tissue showed chronic inflammation and fibrosis in the muscles of the bipedal SAMP8 group. Conclusions. The SAMP8 mouse model can be taken as a clinically relevant model of DKS, and accelerated aging of the musculoskeletal system promotes the development of kyphosis.

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Section: Discussionmentioning

confidence: 99%

The Establishment of a Mouse Model for Degenerative Kyphoscoliosis Based on Senescence-Accelerated Mouse Prone 8

Tang

Kiram

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Several studies reported lower preoperative thoracolumbar muscle quality in patients with proximal junctional kyphosis (PJK) and even muscle degeneration as a risk factor for occurrence of PJK (39)(40)(41). Furthermore, several studies reported that poor muscle quality is correlated with distal screw loosening in patients with DS after corrective surgery (42)(43)(44).…”

Section: Discussionmentioning

confidence: 99%

The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis

Kiram¹,

Hu²,

Man³

et al. 2022

Quant Imaging Med Surg

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Background Coronal imbalance in degenerative scoliosis is common and is highly correlated with health-related quality of life. Paraspinal muscle is critical to spine stability, but little is known about its contribution to coronal imbalance in degenerative scoliosis. This study aims to investigate the relationship between paraspinal muscle (PSM) degeneration and coronal imbalance in patients with degenerative scoliosis (DS). Methods This is a retrospective cohort study. A total of 117 patients with DS were retrospectively reviewed. Parameters of PSM (bilateral cross-sectional area, CSA; fat infiltration rate, FI%) at the apical disc and adjacent levels were quantitatively evaluated using MRI. Standing whole-spine radiograph was used to evaluate the coronal (Cobb angle, CA; coronal balance distance, CBD) and sagittal (thoracic kyphosis, TK; lumbar lordosis, LL; sagittal vertical axis, SVA) parameters. Patients were divided into 3 groups: coronal balanced (Type A), coronal imbalanced shifting to concavity (Type B), and coronal imbalanced shifting to convexity (Type C). Results Based on our criteria, 56 patients were assigned to Type A, 34 patients to Type B, and 27 patients to Type C. There was no significant difference on the sagittal profiles and CSA between the groups. However, Type A showed significantly lower FI% than Type B and Type C on both concavity and convexity (Concave side: Type A vs. Type B vs. Type C, 30.8±8.1 vs. 45.1±7.7 vs. 38.7±12.5, P=0.001; Convex side: Type A vs. Type B vs. Type C, 32.6±10.9 vs. 46.3±7.3 vs. 40.7±11.8, P=0.004). Specifically, Cobb angle was negatively correlated with CSA, mainly at convexity (R=−0.415, P=0.008). Similarly, the increase of CBD significantly correlated with FI% at concavity (R=0.491, P=0.001) and convexity (R=0.354, P=0.025). Conclusions DS patients with coronal imbalance demonstrated a worse PSM degeneration when compared with those without coronal imbalance. Besides, PSM degeneration strongly correlated with coronal imbalance, which implies that PSM degeneration may contribute to the coronal imbalance in patients with DS.

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“…This is probably because, in predisposed subjects, from the biomechanical point of view, the pushing force of the paravertebral muscles is lost, which is essential to counteract the establishment and evolution of the scoliotic curve [ 26 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies [ 34 , 35 , 45 ] have hypothesized that the relationship between low body mass index and scoliosis may be a consequence of hormonal problems [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Is There a Relationship between Idiopathic Scoliosis and Body Mass? A Scoping Review

et al. 2022

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The etiopathogenesis of idiopathic scoliosis remains unknown, although genetic or hereditary factors, neurological disorders, hormonal and metabolic dysfunctions, biomechanical factors, and environmental factors seem to be involved. Several studies have found that patients with scoliosis have common characteristics of taller stature, lower body mass index (BMI), and low systemic bone mass. We conducted a scoping review to analyze the association between idiopathic scoliosis and BMI. The search for articles was performed on PubMed and Cochrane, including the English language, full-text and free-full-text articles published from 31 December 2011 to 31 December 2021. Most of the results analyzed are in favor of a relationship between low BMI and scoliosis. Having a low BMI could be associated with the presence of scoliosis, although the reason for which is still doubtful. However, further large-scale epidemiological studies on different ethnicities and a comparison of BMI with the healthy population will be needed to better define the correlation between BMI and scoliosis.

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Risk factors for screw loosening in patients with adult degenerative scoliosis: the importance of paraspinal muscle degeneration

Cited by 16 publications

References 32 publications

The Establishment of a Mouse Model for Degenerative Kyphoscoliosis Based on Senescence-Accelerated Mouse Prone 8

The Establishment of a Mouse Model for Degenerative Kyphoscoliosis Based on Senescence-Accelerated Mouse Prone 8

The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis

Is There a Relationship between Idiopathic Scoliosis and Body Mass? A Scoping Review

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