The fatty infiltration into cervical paraspinal muscle as a predictor of postoperative outcomes: A controlled study based on hybrid surgery

He, Junbo; Wu, Tingkui; Ding, Chen; Wang, Beiyu; Hong, Ying; Líu, Hao

doi:10.3389/fendo.2023.1128810

Cited by 4 publications

(6 citation statements)

References 36 publications

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“…He et al. observed a degeneration rate of 69.1% in the paraspinal muscles (Goutallier Grade ≥1.5) among patients with two-level cervical disc degenerative disease ( 24 ). They also identified a significant positive correlation between severe paraspinal muscle degeneration and postoperative sagittal balance disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, the degree of muscle fat infiltration at the C5/6 level was exclusively chosen as a surrogate for the entirety of cervical muscle. While this approach has been employed in prior research ( 24 , 35 ), it may not accurately reflect the actual mass of cervical muscles. Besides, although we measured muscle fat infiltration based on previously published reports, we acknowledge that potentially inherent radiographic imaging error might be a significant limitation.…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the operation, qualitative and quantitative evaluations of CPM were performed on an axial T2 weight section obtained from MRI. The degree of muscle fat infiltration at the C5/6 level was chosen as a representative measure of the cervical muscle, consistent with established practice in prior research ( 24 , 35 ). The Goutallier classification was employed to assess the degree of fatty infiltration in the CPM prior to ACDF surgery, as documented in previous studies ( 24 , 35 ).…”

Section: Methodsmentioning

confidence: 99%

“…The degree of muscle fat infiltration at the C5/6 level was chosen as a representative measure of the cervical muscle, consistent with established practice in prior research ( 24 , 35 ). The Goutallier classification was employed to assess the degree of fatty infiltration in the CPM prior to ACDF surgery, as documented in previous studies ( 24 , 35 ). The Goutallier grading system utilizes scores ranging from 0 to 4, with 0 indicating the absence of visible fat streaks in the multifidus, 1 indicating minimal fatty streaks, 2 indicating a greater proportion of muscle than fat, 3 indicating equal amounts of fat and muscle, and 4 indicating a greater proportion of fat than muscle ( Table 1 , Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…The cervical paraspinal muscle (CPM) is a vital component of the dynamic spinal stabilization system, serving a critical function in preserving the stability and mobility of the neck ( 24 ). Through the recruitment of muscles and reflex responses of the nervous system, the neck muscles and tendons provide sufficient stability and regulate cervical motion.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the effectiveness of zero-profile device and plate cage construct in the treatment of one-level cervical disc degenerative disease combined with moderate to severe paraspinal muscle degeneration

Abudouaini,

Xu,

Yang

et al. 2023

Front. Endocrinol.

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ObjectiveRecent evidence indicates that cervical paraspinal muscle degeneration (PMD) is a prevalent and age-related condition in patients with cervical disc degenerative disease (CDDD). However, the relationship between surgery selection and post-operative outcomes in this population remains unclear. Consequently, this study aims to investigate the disparities in clinical outcomes, radiological findings, and complications between two frequently utilized anterior cervical surgical procedures. The objective is to offer guidance for the management of PMD in conjunction with CDDD.MethodsA total of 140 patients who underwent single-level anterior cervical discectomy and fusion (ACDF) at our department were included in this study. The patients were divided into three groups based on the severity of PMD: mild (n=40), moderate (n=54), and severe (n=46), as determined by Goutalier fat infiltration grade. The subjects of interest were those with moderate-severe PMD, and their clinical outcomes, radiological parameters, and complications were compared between those who received a stand-alone zero-profile anchored cage (PREVAIL) and those who received a plate-cage construct (PCC).ResultsThe JOA, NDI, and VAS scores exhibited significant improvement at all postoperative intervals when compared to baseline, and there were no discernible differences in clinical outcomes between the two groups. While the PCC group demonstrated more pronounced enhancements and maintenance of several sagittal alignment parameters, such as the C2-7 angle, FSU angle, C2-7 SVA, and T1 slope, there were no statistically significant differences between the two groups. The incidence of dysphagia in the zero-profile group was 22.41% at one week, which subsequently decreased to 13.79% at three months and 3.45% at the final follow-up. In contrast, the plate cage group exhibited a higher incidence of dysphagia, with rates of 47.62% at one week, 33.33% at three months, and 11.90% at the final follow-up. Notably, there were significant differences in the incidence of dysphagia between the two groups within the first three months. However, the fusion rate, occurrence of implant subsidence, and adjacent segment degeneration (ASD) were comparable at the final follow-up.ConclusionFor patients with one-level cervical disc degenerative disease combined with paraspinal muscle degeneration, both the zero-profile technique and PCC have demonstrated efficacy in ameliorating clinical symptoms and maintaining the postoperative sagittal balance. Although no significant disparities were observed between these two technologies in terms of complications such as adjacent segment degeneration and implant subsidence, the zero-profile technique exhibited superior performance over PCC in relation to dysphagia during the early stages of postoperative recovery. To validate these findings, studies with longer follow-up periods and evaluations of multilevel cervical muscles are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%