STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate the relationship between trunk muscle cross-sectional area (MCSA) and fusion rate after posterior lumbar interbody fusion using pedicle screw fixation (PLIF-PSF). SUMMARY OF BACKGROUND DATA: Although trunk muscles of the lumbar spine contribute to spinal stability and alignment, effect of trunk muscles on spinal fusion rate and time to fusion is unclear. METHODS: A total of 192 adult patients with degenerative lumbar disease who underwent PLIF-PSF at L3-L4 or L4-L5 were included. The MCSA of the flexor (psoas major, PS), extensor (erector spinae, ES; multifidus, MF) were measured using preoperative lumbar magnetic resonance imaging at 3 segments. Bone union was evaluated using lumbar dynamic plain radiography. Patients were divided into 2 groups according to the presence of bone fusion. RESULTS: Most PS MCSAs in the fusion group were significantly larger than in the nonfusion group, except for MCSA at the L2-L3 segment (all P<0.05). In cases of ES and MF MCSAs, 4 of 6 segments were significantly large. Multivariate analysis revealed that the PS MCSA at L4-L5 was an independent factor for decreased possibility of nonfusion status in both segments (OR=0.812, P=0.028). Pearson analysis demonstrated that the most trunk MCSAs were negatively correlated with time to fusion for both segments and PS MCSAs exhibited a significant correlation with time to fusion except for MCSA at the L2-L3 segment. CONCLUSIONS: Trunk MCSAs were significantly larger for a fusion group than a nonfusion group. As trunk MCSAs increased, fusion timing decreased.
STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate the relationship between trunk muscle cross-sectional area (MCSA) and fusion rate after posterior lumbar interbody fusion using pedicle screw fixation (PLIF-PSF). SUMMARY OF BACKGROUND DATA: Although trunk muscles of the lumbar spine contribute to spinal stability and alignment, effect of trunk muscles on spinal fusion rate and time to fusion is unclear. METHODS: A total of 192 adult patients with degenerative lumbar disease who underwent PLIF-PSF at L3-L4 or L4-L5 were included. The MCSA of the flexor (psoas major, PS), extensor (erector spinae, ES; multifidus, MF) were measured using preoperative lumbar magnetic resonance imaging at 3 segments. Bone union was evaluated using lumbar dynamic plain radiography. Patients were divided into 2 groups according to the presence of bone fusion. RESULTS: Most PS MCSAs in the fusion group were significantly larger than in the nonfusion group, except for MCSA at the L2-L3 segment (all P<0.05). In cases of ES and MF MCSAs, 4 of 6 segments were significantly large. Multivariate analysis revealed that the PS MCSA at L4-L5 was an independent factor for decreased possibility of nonfusion status in both segments (OR=0.812, P=0.028). Pearson analysis demonstrated that the most trunk MCSAs were negatively correlated with time to fusion for both segments and PS MCSAs exhibited a significant correlation with time to fusion except for MCSA at the L2-L3 segment. CONCLUSIONS: Trunk MCSAs were significantly larger for a fusion group than a nonfusion group. As trunk MCSAs increased, fusion timing decreased.
Authors: E Quarto; A Zanirato; M Pellegrini; S Vaggi; F Vitali; S Bourret; J C Le Huec; M Formica Journal: Eur Spine J Date: 2022-09-25 Impact factor: 2.721
Authors: Maximilian Muellner; Henryk Haffer; Erika Chiapparelli; Yusuke Dodo; Ek T Tan; Jennifer Shue; Jiaqi Zhu; Andrew A Sama; Frank P Cammisa; Federico P Girardi; Alexander P Hughes Journal: Eur Spine J Date: 2022-08-29 Impact factor: 2.721
Authors: Kevin He; Jeffery Head; Nikolaos Mouchtouris; Kevin Hines; Phelan Shea; Richard Schmidt; Christian Hoelscher; Geoffrey Stricsek; James Harrop; Ashwini Sharan Journal: Global Spine J Date: 2019-10-09