Y Kawaguchi1, H Matsui, H Tsuji. 1. Department of Orthopaedic Surgery, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Abstract
STUDY DESIGN: The histologic and histochemical changes in back muscle were studied in virgin surgery patients with lumbar spine disorders and in patients who underwent repeat posterior lumbar surgery. OBJECTIVES: The results were correlated to provide the evidences of histologic changes of back muscle after posterior lumbar surgery. SUMMARY OF BACKGROUND DATA: Back muscles were examined histologically and histochemically after posterior lumbar surgery. No previous study has assessed these changes. METHODS: Back muscles were obtained before and after retraction from 18 virgin surgery cases with lumbar spine disorders. In four patients, the retraction pressure was monitored and the retraction pressure-time products ([P][T]) were calculated. In 21 repeat lumbar surgery cases, muscle samples were obtained before muscle retraction. Samples were evaluated by histologic and histochemical methods. RESULTS: Abnormal findings were slight in virgin surgery cases. Early back muscle injury tended to depend on operation time and [P][T] products. Late back muscle injury in reoperated patients was marked. Various types of neurogenic changes were observed more than 10 months after the first operation. CONCLUSIONS: Histologic damages of back muscle due to previous surgical intervention were long-lasting. To avoid permanent muscle injury, the retraction time and pressure should be shortened or the pressure on the back muscle should be monitored during posterior surgery.
STUDY DESIGN: The histologic and histochemical changes in back muscle were studied in virgin surgery patients with lumbar spine disorders and in patients who underwent repeat posterior lumbar surgery. OBJECTIVES: The results were correlated to provide the evidences of histologic changes of back muscle after posterior lumbar surgery. SUMMARY OF BACKGROUND DATA: Back muscles were examined histologically and histochemically after posterior lumbar surgery. No previous study has assessed these changes. METHODS: Back muscles were obtained before and after retraction from 18 virgin surgery cases with lumbar spine disorders. In four patients, the retraction pressure was monitored and the retraction pressure-time products ([P][T]) were calculated. In 21 repeat lumbar surgery cases, muscle samples were obtained before muscle retraction. Samples were evaluated by histologic and histochemical methods. RESULTS: Abnormal findings were slight in virgin surgery cases. Early back muscle injury tended to depend on operation time and [P][T] products. Late back muscle injury in reoperated patients was marked. Various types of neurogenic changes were observed more than 10 months after the first operation. CONCLUSIONS: Histologic damages of back muscle due to previous surgical intervention were long-lasting. To avoid permanent muscle injury, the retraction time and pressure should be shortened or the pressure on the back muscle should be monitored during posterior surgery.
Authors: Bertrand Moal; Nicolas Bronsard; José G Raya; Jean Marc Vital; Frank Schwab; Wafa Skalli; Virginie Lafage Journal: World J Orthop Date: 2015-10-18
Authors: Varun Puvanesarajah; Jason A Liauw; Sheng-fu Lo; Ioan A Lina; Timothy F Witham; Allan Gottschalk Journal: Neurosurg Rev Date: 2015-02-14 Impact factor: 3.042