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Importance of the cervical paraspinal muscles in postoperative patient-reported outcomes and maintenance of sagittal alignment after anterior cervical discectomy and fusion.
- Source :
-
Journal of neurosurgery. Spine [J Neurosurg Spine] 2024 May 03; Vol. 41 (2), pp. 149-158. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024). - Publication Year :
- 2024
-
Abstract
- 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).<br />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.<br />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.<br />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.
- Subjects :
- Humans
Female
Male
Middle Aged
Adult
Lordosis surgery
Lordosis diagnostic imaging
Aged
Treatment Outcome
Retrospective Studies
Magnetic Resonance Imaging
Postoperative Period
Diskectomy methods
Spinal Fusion methods
Cervical Vertebrae surgery
Cervical Vertebrae diagnostic imaging
Patient Reported Outcome Measures
Paraspinal Muscles diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1547-5646
- Volume :
- 41
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery. Spine
- Publication Type :
- Academic Journal
- Accession number :
- 38701526
- Full Text :
- https://doi.org/10.3171/2024.2.SPINE23926