Severity of degenerative lumbar spinal stenosis affects pelvic rigidity during walking

Bumann, Helen; Nüesch, Corina; Loske, Stefan; Byrnes, S. Kimberly; Kovács, Balazs; Janssen, Ruben; Schären, Stefan; Netzer, Cordula

doi:10.1016/j.spinee.2019.08.016

Cited by 26 publications

(19 citation statements)

References 37 publications

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“…For qualitative analysis, Goutallier grade (GG) system has been used extensively in CT and MRI studies of rotator cuff muscles [10][11][12]. However, there has been no standardized grading system to evaluate degenerative changes of paraspinal muscles in patients; several studies have applied the GG system to lumbar paraspinal muscles [2,6,10,11,13]. Lumbar paraspinal muscles are composed of various muscles and degree of fatty change varies according to lumbar level 18 ; therefore, GG system has to be further validated in application to paraspinal muscles.…”

Section: Introductionmentioning

confidence: 99%

Paraspinal back muscles in asymptomatic volunteers: quantitative and qualitative analysis using computed tomography (CT) and magnetic resonance imaging (MRI)

Khil

Choi

Hwang

et al. 2020

BMC Musculoskelet Disord

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Background: To evaluate paraspinal back muscles of asymptomatic subjects using qualitative and quantitative analysis on CT and MRI and correlate the results with demographic data. Methods: Twenty-nine asymptomatic subjects were enrolled prospectively (age: mean 34.31, range 23-50; 14 men, 15 women) from August 2016 to April 2017. Qualitative analysis of muscles was done using Goutallier's system on CT and MRI. Quantitative analysis entailed cross sectional area (CSA) on CT and MRI, Hounsfield unit (HU) on CT, fat fraction using two-point Dixon technique on MRI. Three readers independently analyzed the images; intra-and inter-observer agreements were measured. Linear regression and Spearman's analyses were used for correlation with demographic data. Results: CSA values were significantly higher in men (p < 0.001). Fat fraction was higher (22.53% vs. 14.35%) and HU lower (36.00 vs. 47.43) in women (p < 0.001). Intra-and inter-observer reliabilities of the two methods were greater than 0.8, except for CSA of L5/S1 on MRI; however, regarding quantitative analysis, decreasing HU and increasing fat fraction were correlated with increasing age, female gender and lower lumbar segment (p < 0.001). Conclusion: MRI and CT can be reliably used for qualitative and quantitative analysis of paraspinal back muscles, regarding fat content. Fat fraction and HU showed highest reliabilities.

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Section: Introductionmentioning

confidence: 99%

Paraspinal back muscles in asymptomatic volunteers: quantitative and qualitative analysis using computed tomography (CT) and magnetic resonance imaging (MRI)

Khil

Choi

Hwang

et al. 2020

BMC Musculoskelet Disord

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“…Because forces exerted by paraspinal muscles are necessary for maintaining an upright posture in patients with LSS one would expect that patients with loss of lordosis need stronger muscles to maintain an upright position. A previous study [5] suggested that there might be a decompensation mechanism in the course of the disease eventually leading to muscle atrophy. In our study, the lack of association between fatty infiltration of paraspinal muscles and LL suggests that patients may have compensatory posterior pelvic rotation (retroversion) that reduces the forces exerted by paraspinal muscles and eventually leads to fatty infiltration, thus influencing the sagittal balance in a vicious cycle resulting in progressive spine degeneration at the intervertebral disc and facet joints.…”

Section: Discussionmentioning

confidence: 97%

“…With the aging population, degenerative lumbar spinal stenosis has become a common disease. Chronic LSS can affect the patient's gait and further affect sagittal spinopelvic alignment [5] . PI, one of the most important sagittal alignment parameters, is a morphological parameter that remains constant after maturity and reflects the relationship between the sacrum and iliac wings [19] .…”

Section: Discussionmentioning

confidence: 99%

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Association between fatty infiltration of paraspinal muscle, sagittal spinopelvic alignment and stenosis grade in patients with degenerative lumbar spinal stenosis

Zhang

Mandelli

Mündermann

et al. 2021

North American Spine Society Journal (NASSJ)

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Introduction: Sagittal balance and fatty infiltration of paraspinal muscle are important factors in patients with lumbar spinal stenosis (LSS) that may affect patients' quality of life. Sagittal spinopelvic parameters and fatty infiltration may be associated with the severity of LSS. The purpose of this study was to test the hypothesis that severity of fatty infiltration correlates with severity of LSS and with sagittal pelvic alignment independent of age.Methods: Age and body mass index (BMI) were extracted. Fatty infiltration was rated according to Goutallier classification and the severity of LSS was graded according to Schizas at five intervertebral disc levels. Overall fatty infiltration was computed as average fatty infiltration (aFI) and severity of LSS was defined as the highest severity of LSS of all segments. The sagittal spinopelvic parameters pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL) and PI-LL were measured. Associations among parameters were assessed using Spearman correlation coefficients adjusted for age ( = 0.05).

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“…It is considered as one of the most common indices of spinal surgery which leads to tumor and spinal dislocation. The high prevalence of degenerative spinal disorders [15,16] in the population leads to large social costs arising from the diagnosis to paralysis. In the industrialized world, low back pain is a major problem, and diagnosing the underlying causes for the back pain can be very difficult.…”

Section: Figure1 Structure Of the Vertebral Bodymentioning

confidence: 99%

Vertebral Tumor Detection and Segmentation Using Analytical Transform Assisted Statistical Characteristic Decomposition Model

et al. 2020

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Recently, vertebral tumor prediction using image-based vertebral bio-mathematical modeling with accurate segmentation has been considered as a significant area of research. Further, precise lumbar spinal segmentation is essential to the clinicians for tumor analysis. Therefore, precise and reliable segmentation process is required to help radiologists and doctors to identify different vertebrae tumors with better prediction ratio. The exact vertebral disks segmentation of spinal bones from medical images is a complex process in dealing with different deformities and pathologies in accordance to the conventional techniques such as Deep Convolutional Neural Network (DCNN), Finite Element Analysis (FEA), Principal Component and Factor Analysis (PCFA), Multi-Parameter Ensemble Learning (MPEL), Hierarchical Conditional Random Forest (HCRF), and Deep Siamese Neural Network (DSNN). Therefore, to overcome the present drawbacks, Analytical Transform Assisted Statistical Characteristic Decomposition Model (ATS-CDM) is proposed in this paper for the accurate prediction of vertebral tumor detection and segmentation. This technique is used for the calibration of the segmentation procedures in vertebral tumor image prediction and Receiver Operating Curve (ROC) grading for the lumbar spines. The significant objective of the model-fitting algorithm iterates the tumor regions and measures the current region's variance for the accurate identification of tumor. The outcomes show potential and promising results at lab scale evaluation through analyzing the vertebral datasets with Intra-Discal Pressure (IDP) images for experimental validation with 98.7% bending and 98.88 % segmentation accuracy leads to 94.2 ± 0.2 % to 97.02 ± 0.2 % average ROC grading.

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Severity of degenerative lumbar spinal stenosis affects pelvic rigidity during walking

Cited by 26 publications

References 37 publications

Paraspinal back muscles in asymptomatic volunteers: quantitative and qualitative analysis using computed tomography (CT) and magnetic resonance imaging (MRI)

Paraspinal back muscles in asymptomatic volunteers: quantitative and qualitative analysis using computed tomography (CT) and magnetic resonance imaging (MRI)

Association between fatty infiltration of paraspinal muscle, sagittal spinopelvic alignment and stenosis grade in patients with degenerative lumbar spinal stenosis

Vertebral Tumor Detection and Segmentation Using Analytical Transform Assisted Statistical Characteristic Decomposition Model

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