Association patterns between lumbar paraspinal muscles and sagittal malalignment in preoperative patients undergoing lumbar three-column osteotomy.

Autor: Caffard T; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.; Department of Orthopedic Surgery, University of Ulm, Ulm, Germany., Medina SJ; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Arzani A; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Chiapparelli E; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Schönnagel L; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.; Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany., Tani S; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.; Department of Orthopaedic Surgery, School of Medicine, Showa University Hospital, Tokyo, Japan., Camino-Willhuber G; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Zhu J; Biostatistics Core, Hospital for Special Surgery, New York City, NY, USA., Dalton D; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Zippelius T; Department of Orthopedic Surgery, University of Ulm, Ulm, Germany., Sama AA; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Cammisa FP; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Girardi FP; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Hughes AP; Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. hughesa@hss.edu.
Jazyk: angličtina
Zdroj: Spine deformity [Spine Deform] 2024 May; Vol. 12 (3), pp. 801-809. Date of Electronic Publication: 2024 Mar 12.
DOI: 10.1007/s43390-024-00828-9
Abstrakt: Purpose: We aim to investigate the associations between lumbar paraspinal muscles and sagittal malalignment in patients undergoing lumbar three-column osteotomy.
Methods: Patients undergoing three-column osteotomy between 2016 and 2021 with preoperative lumbar magnetic resonance imaging (MRI) and whole spine radiographs in the standing position were included. Muscle measurements were obtained using a validated custom software for segmentation and muscle evaluation to calculate the functional cross-sectional area (fCSA) and percent fat infiltration (FI) of the m. psoas major (PM) as well as the m. erector spinae (ES) and m. multifidus (MM). Spinopelvic measurements included pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), L1-S1 lordosis (LL), T4-12 thoracic kyphosis (TK), spino-sacral angle (SSA), C7-S1 sagittal vertical axis (SVA), T1 pelvic angle (TPA) and PI-LL mismatch (PI - LL). Statistics were performed using multivariable linear regressions adjusted for age, sex, and body mass index (BMI).
Results: A total of 77 patients (n = 40 female, median age 64 years, median BMI 27.9 kg/m 2 ) were analyzed. After adjusting for age, sex and BMI, regression analyses demonstrated that a greater fCSA of the ES was significantly associated with greater SS and SSA. Moreover, our results showed a significant correlation between a greater FI of the ES and a greater kyphosis of TK.
Conclusion: This study included a large patient cohort with sagittal alignment undergoing three-column osteotomy and is the first to demonstrate significant associations between the lumbar paraspinal muscle parameters and global sagittal alignment. Our findings emphasize the importance of the lumbar paraspinal muscles in sagittal malalignment.
(© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.)
Databáze: MEDLINE
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