Importance of the cervical paraspinal muscles in postoperative patient-reported outcomes and maintenance of sagittal alignment after anterior cervical discectomy and fusion.

Autor:	Caffard T; 1Spine Care Institute, Hospital for Special Surgery, New York, New York.; 2Department of Orthopedic Surgery, University of Ulm, Germany., Arzani A; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Verna B; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Tripathi V; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Chiapparelli E; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Schönnagel L; 1Spine Care Institute, Hospital for Special Surgery, New York, New York.; 3Center for Musculoskeletal Surgery, University of Berlin, Germany., Zhu J; 4Biostatistics Core, Hospital for Special Surgery, New York, New York., Medina SJ; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Tani S; 1Spine Care Institute, Hospital for Special Surgery, New York, New York.; 5Department of Orthopaedic Surgery, School of Medicine, Showa University Hospital, Tokyo, Japan; and., Camino-Willhuber G; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Guven AE; 1Spine Care Institute, Hospital for Special Surgery, New York, New York.; 3Center for Musculoskeletal Surgery, University of Berlin, Germany., Amoroso K; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Tan ET; 6Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York., Carrino JA; 6Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York., Shue J; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Dobrindt O; 2Department of Orthopedic Surgery, University of Ulm, Germany., Zippelius T; 2Department of Orthopedic Surgery, University of Ulm, Germany., Dalton D; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Sama AA; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Girardi FP; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Cammisa FP; 1Spine Care Institute, Hospital for Special Surgery, New York, New York., Hughes AP; 1Spine Care Institute, Hospital for Special Surgery, New York, New York.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Spine [J Neurosurg Spine] 2024 May 03, pp. 1-10. Date of Electronic Publication: 2024 May 03.
DOI:	10.3171/2024.2.SPINE23926
Abstrakt:	Objective: The aim of this study was to investigate the influence of preoperatively assessed paraspinal muscle parameters on postoperative patient-reported outcomes and maintenance of cervical sagittal alignment after anterior cervical discectomy and fusion (ACDF). Methods: Patients with preoperative and postoperative standing cervical spine lateral radiographs and preoperative cervical MRI who underwent an ACDF between 2015 and 2018 were reviewed. Muscles from C3 to C7 were segmented into 4 functional groups: anterior, posteromedial, posterolateral, and sternocleidomastoid. The functional cross-sectional area and also the percent fat infiltration (FI) were calculated for all groups. Radiographic alignment parameters collected preoperatively and postoperatively included C2-7 lordosis and C2-7 sagittal vertical axis (SVA). Neck Disability Index (NDI) scores were recorded preoperatively and at 2 and 4-6 months postoperatively. To investigate the relationship between muscle parameters and postoperative changes in sagittal alignment, multivariable linear mixed models were used. Multivariable linear regression models were used to analyze the correlations between the changes in NDI scores and the muscles' FI. Results: A total of 168 patients with NDI and 157 patients with sagittal alignment measurements with a median follow-up of 364 days were reviewed. The mixed models showed that a greater functional cross-sectional area of the posterolateral muscle group at each subaxial level and less FI at C4-6 were significantly associated with less progression of C2-7 SVA over time. Moreover, there was a significant correlation between greater FI of the posteromedial muscle group measured at the C7 level and less NDI improvement at 4-6 months after ACDF. Conclusions: The findings highlight the importance of preoperative assessment of the cervical paraspinal muscle morphology as a predictor for patient-reported outcomes and maintenance of C2-7 SVA after ACDF.
Databáze:	MEDLINE
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