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Purpose: This study aimed to investigate the impact of sarcopenia and lumbar paraspinal muscle composition (PMC) on patient-reported outcomes (PROs) after lumbar fusion surgery with 12-month follow-up (12 M-FU). Methods: A prospective investigation of patients undergoing elective lumbar fusion was conducted. Preoperative MRI-based evaluation of the cross-sectional area (CSA), the functional CSA (fCSA), and the fat infiltration(FI) of the posterior paraspinal muscles (PPM) and the psoas muscle at level L3 was performed. Sarcopenia was defined by the psoas muscle index (PMI) at L3 (CSAPsoas [cm2]/(patients' height [m])2). PROs included Oswestry Disability Index (ODI), 12-item Short Form Healthy Survey with Physical (PCS-12) and Mental Component Scores (MCS-12) and Numerical Rating Scale back and leg (NRS-L) pain before surgery and 12 months postoperatively. Univariate and multivariable regression determined associations among sarcopenia, PMC and PROs. Results: 135 patients (52.6% female, 62.1 years, BMI 29.1 kg/m2) were analyzed. The univariate analysis demonstrated that a higher FI (PPM) was associated with worse ODI outcomes at 12 M-FU in males. Sarcopenia (PMI) and higher FI (PPM) were associated with worse ODI and MCS-12 at 12 M-FU in females. Sarcopenia and higher FI of the PPM are associated with worse PCS-12 and more leg pain in females. In the multivariable analysis, a higher preoperative FI of the PPM (β = 0.442; p = 0.012) and lower FI of the psoas (β = −0.439; p = 0.029) were associated with a worse ODI at 12 M-FU after adjusting for covariates. Conclusions: Preoperative FI of the psoas and the PPM are associated with worse ODI outcomes one year after lumbar fusion. Sarcopenia is associated with worse ODI, PCS-12 and NRS-L in females, but not males. Considering sex differences, PMI and FI of the PPM might be used to counsel patients on their expectations for health-related quality of life after lumbar fusion. [ABSTRACT FROM AUTHOR]

It has not been fully elucidated that nutritional parameters affect the change of activities of daily living (ADL) during pneumonia treatment. This study assessed the impact of nutritional status, including erector spinae muscle (ESM) size on ADL changes from admission to discharge among older patients with community-acquired pneumonia (CAP). We retrospectively included patients (age: ≥65 years) who were admitted to the hospital for CAP and underwent chest computed tomography (CT) on admission. ADL was evaluated using the Barthel index, and patients were divided into the maintained or improved ADL group and the declined ADL group from admission through discharge. The ESM cross-sectional area was measured on a single-slice CT image. Logistic regression models were applied for assessing factors associated with changes in ADL. A total of 523 patients hospitalized for CAP (median age 86 years) were evaluated. The declined group had significantly higher ADL levels on admission, a greater frequency of smoking history and malignancy, and a lower frequency of cerebrovascular disease and dementia. No significant difference in ESM size was observed between the groups. Multivariate analysis revealed that higher ADL levels on admission (odds ratio 1.034, interquartile range 1.026–1.043) and malignancy (3.002, 1.150–7.836) were associated with a decline in ADL, whereas cerebrovascular disease (0.579, 0.373–0.900) was related to improvement or maintenance of ADL. Although nutritional status might not affect the change of ADL among older patients hospitalized with pneumonia, a cerebrovascular disease history may be a good predictor for ADL improvement. [ABSTRACT FROM AUTHOR]

Background: Percutaneous nephrolithotomy (PCNL) is a standard procedure to remove and disintegrate large kidney stones. Despite minimal invasiveness, it is associated with significant postoperative pain. Erector spinae plane block (ESPB) is a novel interfacial plane block recently introduced to provide analgesia in acute and chronic pain. The current study was conducted to compare the efficacy of ultrasound (USG) guided ESPB and conventional analgesia (CA) following PCNL. Methodology: After obtaining the institute's ethical committee approval and informed consent, 50 patients were included in the study and were randomized into two equal groups of 25 to receive ESPB with 20 ml of 0.25% bupivacaine or CA. Patients in both groups were given intravenous paracetamol 8th hourly and intravenous tramadol 2mg/kg as rescue analgesia. Results: Both study and control groups were similar in demographic profile. Pain assessment by Visual analogue scale (VAS) scores in the postoperative period were significantly lower at hours of 20min, 40min, and 1,3,6,12 hrs (P<0.0001) and at 9,18 hrs (P<0.05) in the group E, than the control group. The time to first rescue analgesia was observed longer in the ESPB group than in the control group (2.28± 0.58hrs Vs 15.48± 3.17 hrs) (P<0.0001). The average tramadol consumption was less in the ESPB group compared to the control group (139.28±41.36 mg Vs 337.20± 38.66mg) (P< 0.0001). Conclusion: Ultrasound-guided ESPB provides safe and effective postoperative analgesia following PCNL, with decreased VAS scores. ESPB extends the retrieval analgesia time and lessen the requirement for tramadol. [ABSTRACT FROM AUTHOR]

Background and Aims: Aspiration pneumonia is generally associated with deterioration of skeletal muscle mass, which is usually evaluated by the erector spinae muscle cross-sectional area (ESMCSA); however, no report has assessed ESMCSA in patients with aspiration pneumonia. Furthermore, erector spinae muscle thickness (ESMT) was developed to be easier to measure than ESMCSA. Therefore, this study investigated the relationship between ESMT and ESMCSA in aspiration pneumonia patients compared to bacterial pneumonia patients. Methods: We retrospectively collected data for 164 patients with aspiration pneumonia and 480 patients with bacterial pneumonia who were hospitalized at Fukujuji Hospital between September 2018 and May 2022. We assessed the correlations between ESMCSA and ESMT and compared the data between the two groups. Results: ESMT had a strong, proportional relationship with ESMCSA in all patients (r = 0.908, p < 0.001) and those with aspiration pneumonia (r = 0.896, p < 0.001). ESMCSA (median 671.8 mm2 [range 164.0–1636.7] vs. median 1057.0 mm2 [range 161.3–2412.5], p < 0.001) and ESMT (median 17.1 mm [range 6.95–34.4] vs. median 23.8 mm [range 6.95–43.7], p < 0.001) were significantly lower in patients with aspiration pneumonia. A multivariate analysis of aspiration pneumonia diagnosis showed significant independent differences from bacterial pneumonia in ESMCSA (odds ratio 0.998 [95% CI: 0.996–0.999], p = 0.001) and ESMT (odds ratio 0.90 [95% CI: 0.84–0.96], p = 0.002). Conclusion: This study demonstrates a strong correlation between ESMCSA and ESMT. ESMT can be more easily used to evaluate skeletal muscle mass and can help in diagnosing aspiration pneumonia. [ABSTRACT FROM AUTHOR]

Aims: Previous studies have shown a significant reduction in skeletal muscle content in patients with chronic heart failure (CHF). The present study focused on the erector spinae muscle (ESM) to determine whether ESM content is associated with the development and severity of CHF. Methods and results: A total of 652 patients were included in this trial for the study. According to the diagnostic criteria of CHF, 652 patients were divided into two groups, namely, the control group (268 patients) and the CHF group (384 patients). Meanwhile, to assess whether the ESM is associated with the severity of CHF, patients in the CHF group were divided into two groups according to left ventricular ejection fraction (LVEF) values: heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%, 256 patients) and heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%, 68 patients). Receiver operating curve analysis was performed to assess whether ESM content could predict CHF and determine its severity. Compared with the control group, the patients in the CHF group were older, the prevalence of coronary heart disease (CHD) and atrial fibrillation was higher, the colour ultrasound results showed that LVEF decreased significantly, and the left ventricular end‐diastolic internal diameter and left ventricular end‐systolic internal diameter increased significantly. Besides, patients in the CHF group had significantly lower ESM content, and ESM is an independent predictor of heart failure, with an odds ratio of 0.713 (CHF group vs. control group, 95% confidence interval 0.626–0.811, P < 0.001). Compared with the HFpEF group, the HFrEF group has a lower prevalence of CHD, LVEF decreased significantly, the left ventricular end‐diastolic internal diameter and left ventricular end‐systolic internal diameter increased significantly, also patients in the HFrEF group had significantly lower ESM content compared with patients in the HFpEF group, and ESM is an independent predictor of the severity of heart failure, with an odds ratio of 0.514 (HFrEF group vs. HFpEF group, 95% confidence interval (0.418–0.633, P < 0.05). The results of receiver operating curve analysis showed that the sensitivity and specificity of ESM content for the diagnosis of CHF were 65.6% and 71.6%, respectively, while the sensitivity and specificity of ESM content for predicting the severity of CHF were 47.1% and 89.1%, respectively. Conclusions: The ESM is of great value in predicting the onset and severity of CHF. [ABSTRACT FROM AUTHOR]

Background: No multivariable model incorporating erector spinae muscle (ESM) has been developed to predict clinical outcomes in older patients with severe community-acquired pneumonia (SCAP). This study aimed to construct a nomogram based on ESM to predict in-hospital mortality in patients with SCAP. Methods: Patients aged ≥ 65 years with SCAP were enrolled in this prospective observational study. Least absolute selection and shrinkage operator and multivariable logistic regression analyses were used to identify risk factors for in-hospital mortality. A nomogram prediction model was constructed. The predictive performance was evaluated using the concordance index (C-index), calibration curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis. Results: A total of 490 patients were included, and the in-hospital mortality rate was 36.1%. The nomogram included the following independent risk factors: mean arterial pressure, peripheral capillary oxygen saturation, Glasgow Coma Scale score (GCS), lactate, lactate dehydrogenase, blood urea nitrogen levels, and ESM cross-sectional area. Incorporating ESM into the base model with other risk factors significantly improved the C-index from 0.803 (95% confidence interval [CI], 0.761–0.845) to 0.836 (95% CI, 0.798–0.873), and these improvements were confirmed by category-free NRI and IDI. The ESM-based nomogram demonstrated a high level of discrimination, good calibration, and overall net benefits for predicting in-hospital mortality compared with the combination of confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65), Pneumonia Severity Index (PSI), Acute Physiology and Chronic Health Evaluation II (APACHEII), and Sequential Organ Failure Assessment (SOFA). Conclusions: The proposed ESM-based nomogram for predicting in-hospital mortality among older patients with SCAP may help physicians to promptly identify patients prone to adverse outcomes. Trial registration: This study was registered at www.chictr.org.cn (registration number Chi CTR-2300070377). [ABSTRACT FROM AUTHOR]

Lumbar stabilization exercises (LSE) lead to high levels of erector spinae muscle (ESM) activation, which has a positive effect on improving physical function. The purpose of this study is to identify factors explaining changes in muscle strength after 7 weeks of LSE and to evaluate changes in stiffness and contraction of the ESM. All participants (male: n = 42, age = 28.26 ± 10.97) were assessed for 60°/s isokinetic extensor muscle strength and tension using a tensiomyography (TMG) and isokinetic device before and after LSE. Maximum displacement (Dm) and average velocity up to 90% Dm (Vc 90) were significantly different before and after LSE. Additionally, participants' 60°/s isokinetic extensor strength was significantly higher after exercise. A regression analysis was conducted to test the explanatory power of the variables, and positive results were obtained in the increase in extensor strength before and after Vc 90 and LSE. Furthermore, statistical significance was set at p < 0.05. After LSE, the increase in 60°/s isokinetic extensor strength and ESM's Dm and Vc 90 can be interpreted as positive changes post-exercise in endurance muscles with a higher percentage of type I fibers. Our results can contribute to predicting the long-term exercise effect in sedentary workers and developing an individualized strategic exercise program. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Erector spinae muscle (ESM) is an antigravity muscle group that can be evaluated as an index of muscle loss on chest computed tomography. The amount of ESM has been reported to be related to the prognosis of several respiratory diseases. However, few studies clarify the impact on postoperative non-small-cell lung cancer (NSCLC). We investigated the relationship between ESM and postoperative prognosis in patients with early-stage NSCLC. METHODS We reviewed the medical records of 534 patients with stage I NSCLC who underwent lobectomy or segmentectomy. The ESM was identified by preoperative computed tomography, and the amount was normalized according to height and sex. Overall survival, lung cancer-related deaths and non-lung cancer-related deaths (NLCRD) were analysed using log-rank and Gray's tests. Multivariable analyses were conducted to identify factors that influenced overall survival (OS) and NLCRD. RESULTS The amount of ESM normalized according to height and sex was significantly associated with age and body mass index. When the amount was low, OS (5-year OS, 79.6 vs 89.5%; P < 0.001) and NLCRD (5-year cumulative mortality rate, 14.7 vs 6.8%; P < 0.001) were significantly worse, although no difference was found in lung cancer-related deaths. CONCLUSIONS The amount of preoperative ESM was strongly related to non-lung cancer-related death and was a significant prognostic factor for stage I NSCLC. Patients with a low amount of the muscle should be treated based on proper risk assessment. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to elaborate the characteristics of paraspinal muscles in lower lumbar, to compare the differences of paraspinal muscle between patients with lumbar spinal stenosis and normal people and to explore the influencing factors of paraspinal muscle degeneration in patients with lumbar spinal stenosis. Method: The 39 pairs of patients and normal people were selected by propensity score matching. The differences of multifidus muscle and erection spine muscle parameters between the two groups were compared by independent-samples t-test and the relationship between age, paraspinal muscle degeneration and other factors in patients with lumbar spinal stenosis was analyzed by Pearson or Spearman correlation analysis. Result: The general conditions of the two groups (patients with lumbar spinal stenosis and normal people) were well matched. There were significant differences in the relative fatty cross sectional area, fatty infiltration and relative signal intensity of multifidus muscle at L3 level. The fatty infiltration and relative signal intensity of multifidus muscle at L4 level and the relative signal intensity of multifidus muscle at L5 level were also significantly different. For male, the relative fatty cross sectional area, the fatty infiltration and relative signal intensity of multifidus muscle in patients were higher than those in healthy peers. For female, the relative signal intensity of multifidus muscle in patients was higher, too. In patients group, age was significantly correlated with the relative fatty cross sectional area, fatty infiltration and relative signal intensity of multifidus muscle and erector spinae muscle. Weight and BMI were significantly correlated with the relative total cross-sectional area of erector spinae muscle. The fatty infiltration increased more significantly with age in patients than that in normal people.Conclusion: The change rules of paraspinal muscles in patients with lumbar spinal stenosis are similar to those in normal people. The degeneration of paraspinal muscle in patients with lumbar spinal stenosis was more severe than that in normal people, mostly in multifidus muscle. The paraspinal muscle degeneration was related to age in patients, and the effect of age on atrophy of paraspinal muscle was greater than that of normal people. [ABSTRACT FROM AUTHOR]

21398167 23 Kim C.-Y., Choi J.-D., Kim S.-Y., Oh D.-W., Kim J.-K., Park J.-W. Comparison between muscle activation measured by electromyography and muscle thickness measured using ultrasonography for effective muscle assessment. EMG, ultrasound imaging, low back pain, erector spinae muscle, thoracolumbar fascia, multifidus muscle, muscle spindle Keywords: EMG; ultrasound imaging; low back pain; thoracolumbar fascia; erector spinae muscle; multifidus muscle; muscle spindle EN EMG ultrasound imaging low back pain thoracolumbar fascia erector spinae muscle multifidus muscle muscle spindle 1735 16 11/17/22 20221101 NES 221101 1. ES, erector spinae muscle; LD, latissimus dorsi muscle; SPI, serratus posterior inferior muscle; TLF, thoracolumbar fascia; sEMG, surface electromyography; orange dot shows the LD/TLF junction. [Extracted from the article]

Introduction The needle electromyography ( EMG) serves to supply additional information in patients with suspected neuromuscular disorders. We aimed to provide motor unit potential ( MUP) data by concentric needle EMG in the erector spinae ( ES) in comparison with biceps brachii ( BB) and lateral vastus ( LV). Methods Electromyography MUP data ( n) were obtained in ES (517), BB (539), and LV (627) in 32 healthy volunteers (16f). Results Motor unit potential data: amplitude (μV) 393 ± 174 ( ES), 375 ± 162 ( BB), and 577 ± 304 ( LV); duration (ms) 10.4 ± 2.4 ( ES), 10.1 ± 2.1 ( BB), and 11.1 ± 2.3 ( LV), area (μV × ms) 585 ± 327 ( ES), 538 ± 267 ( BB), and 881 ± 492 ( LV); phase number 3.23 ± 0.94 ( ES), 2.98 ± 0.76 ( BB), and 3.19 ± 0.81 ( LV); size index 0.60 ± 0.56 ( ES), 0.51 ± 0.53 ( BB), and 0.96 ± 0.55 ( LV). LV displayed higher values ( p at least <.001) for MUP amplitude, duration, area, and size index as compared to both, BB and ES. Conclusion Concentric needle EMG investigations in healthy adult human subjects revealed similar MUP parameters in the ES and BB muscles, while in the LV muscle MUP amplitude, duration, area, and size index were significantly larger. Different neuromuscular disorders display a predominant involvement of proximally located muscles such as truncal muscles. The present results given here may facilitate the diagnosis of neuromuscular disorders. [ABSTRACT FROM AUTHOR]

Erector spinae muscle, Early non-small-cell lung cancer, Postoperative prognosis, Sarcopenia In addition, the erector spinae muscle was associated with physical inactivity as an anti-gravity muscle [[5]]. Keywords: Erector spinae muscle; Early non-small-cell lung cancer; Postoperative prognosis; Sarcopenia EN Erector spinae muscle Early non-small-cell lung cancer Postoperative prognosis Sarcopenia 1 1 1 07/04/23 20230601 NES 230601 We would like to thank Dr. Zhou and Yu for their thoughtful consideration of our paper 'Impact of the amount of preoperative erector spinae muscle in stage I non-small-cell lung cancer' [[1]]. [Extracted from the article]

Sarcopenia, Lung cancer, Prognosis, Erector spinae muscle Keywords: Sarcopenia; Lung cancer; Erector spinae muscle; Prognosis EN Sarcopenia Lung cancer Erector spinae muscle Prognosis 1 1 1 07/04/23 20230601 NES 230601 To the Editor, We read with great interest the article [[1]] that reviewed 534 patients with stage I NSCLC who underwent lobectomy or segmentectomy. [Extracted from the article]

BACKGROUND: The erector spinae is more resistant to fatigue in adult women than men. However, no study has reported the sex differences in back muscle fatigue in children. OBJECTIVE: The aim of this study was to evaluate the fatigability of erector spinae in prepubertal children and adults, in both males and females. METHODS: Fourteen prepubertal boys, 13 prepubertal girls, 14 adult men, and 13 adult women performed the Sørensen back isometric endurance test until exhaustion. The results of electromyographic (EMG) power spectral analysis of erector spinae were compared between both age groups and sexes. RESULTS: The slopes of EMG power spectral median and mean power frequency were significantly higher in males than in females, in both age groups. Furthermore, the slopes were significantly lower in prepubertal children than in adults, in both males and females. CONCLUSIONS: Our results showed major differences in the fatigue threshold of the erector spinae between boys and girls and children and adults. The muscle fatigued faster in prepubertal boys and adult men than in prepubertal girls and adult women. In both sexes, a lower slope of EMG power spectrum parameters of the erector spinae was noted during endurance test in prepubertal children compared to adults. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous literatures showed no evidence that wearing an external breast prosthesis may prevent changes in body posture in women who underwent mastectomy. OBJECTIVE: To determine whether the weight of an external breast prosthesis can contribute to posture changes in women post mastectomy. METHODS: Fifty-one women with unilateral mastectomy (age 58 ± 11.39 years) were divided into 2 subgroups by their operation side. Asymmetry of body posture was evaluated by using the electromyography activity of erector spinae muscles with four different weights of breast prosthesis. RESULTS: Despite the operation side, the erector spinae muscle activities on the operation side and non-operation side were significantly different. Overall, for patients who had operation on the left side, their erector spinae muscle activity imbalance will be smaller, compared to the imbalance among patients with right operation side. The weight of the external breast prosthesis did not influence the differences of erector spinae muscle activities on the operation side and non-operation side. CONCLUSIONS: The weight of an external breast prosthesis for women after mastectomy may not be crucial when choosing a proper prosthesis. [ABSTRACT FROM AUTHOR]

This study investigates whether sweep rowers activate their low back muscles asymmetrically when exercising on a rowing ergometer. Given that indoor rowing imposes equal loading demands to left and right back muscles, any side differences in activation are expected to reflect asymmetric adaptations resulting from sweep rowing. In addition to trunk kinematics, surface electromyograms ( EMGs) were sampled from multiple skin locations along the lumbar spine of six elite, sweep rowers. The distribution of EMG amplitude along the spine was averaged across strokes and compared between sides. Key results indicate a significant effect of trunk side on EMG amplitude and on the low back region where EMG amplitude was greatest. Such side differences were unlikely because of trunk lateral inclination and rotation, which were smaller than 5° for all rowers tested. Moreover, asymmetries manifested differently between participants; there was not a clear predominance of greater EMG amplitude toward the right/left side in portside/starboard rowers. These results suggest that (a) even during indoor rowing, sweep rowers activate asymmetrically their low back muscles; (b) factors other than rowing side might be associated with low back asymmetries; (c) spatial distribution of surface EMG amplitude is sensitive to bilateral changes in back muscles' activation. [ABSTRACT FROM AUTHOR]

Abstract: Background context: Previous studies reported that the erector spinae muscle is more resistant to fatigue in healthy adult women than in men. However, no study has reported changes in back muscle fatigue with aging in healthy men and women. Purpose: The aim of this study was to evaluate age-related changes in muscle fatigue of erector spinae muscle in men and women. Study design/setting: This cross-sectional study was conducted in a laboratory. Patient sample: Fifty-three healthy subjects (11 elderly men, 11 elderly women, 17 young men, and 14 young women) without low back pain history. Outcome measures: The median frequency (MF) and mean power frequency (MPF) during trunk holding test were derived from the raw electromyographic (EMG) signal using Fast Fourier Transform spectrum analysis program. The rates of changes in MF and MPF were calculated. Methods: Subjects performed the unsupported trunk holding test until exhaustion. The results of power spectral analysis of the EMG activity of the left erector spinae muscle were compared in both age groups and sexes. Results: The endurance time in young men was significantly shorter than in young women. The slopes of MF and MPF in young men were significantly higher than in young women. There were no significant differences in MF and MPF slopes of elderly men and elderly women. Furthermore, the MF and MPF slopes were significantly lower in elderly men than young men but similar in the two women groups. Conclusions: Age-related changes in the slopes of MF and MPF of erector spinae muscle occur in healthy men but not in healthy women. [Copyright &y& Elsevier]

• An efficient stress detection method has been developed based on EMG and ECG signals. • A comparison between the performance of EMG and ECG for multi-level stress detection has been represented. • The accuracies of stress recognition for two, three and four levels obtained as 100%, 97.3%, and 95.4 %, respectively. In recent years, stress and mental health have been considered as important worldwide concerns. Stress detection using physiological signals such as electrocardiogram (ECG), skin conductance (SC), electromyogram (EMG) and electroencephalogram (EEG) is a traditional approach. However, the effect of stress on the EMG signal of different muscles and the efficacy of combination of the EMG and other biological signals for stress detection have not been taken into account yet. This paper presents a comprehensive review of the EMG signal of the right and left trapezius and right and left erector spinae muscles for multi-level stress recognition. Also, the ECG signal was employed to evaluate the efficacy of EMG signals for stress detection. Both EMG and ECG signals were acquired simultaneously from 34 healthy students (23 females and 11 males, aged 20-37 years). Mental arithmetic, Stroop color-word test, time pressure, and stressful environment were employed to induce stress in the laboratory. The accuracies of stress recognition in two, three and four levels were 100%, 97.6%, and 96.2%, respectively, obtained from the distinct combination of feature selection and machine learning algorithms. The comparison of stress detection accuracies resulted from EMG and ECG indicators demonstrated the strong ability and the effectiveness of EMG signal for multi-level stress detection. [ABSTRACT FROM AUTHOR]