Preoperative fatty infiltration of paraspinal muscles assessed by MRI is associated with less improvement of leg pain 2 years after surgery for lumbar spinal stenosis.
Magnetic Resonance Imaging
Outcome measure
Paraspinal muscles
Regression
Spinal stenosis
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
25 Mar 2024
25 Mar 2024
Historique:
received:
10
11
2023
accepted:
01
03
2024
revised:
08
02
2024
medline:
26
3
2024
pubmed:
26
3
2024
entrez:
26
3
2024
Statut:
aheadofprint
Résumé
Fatty infiltration (FI) of the paraspinal muscles may associate with pain and surgical complications in patients with lumbar spinal stenosis (LSS). We evaluated the prognostic influence of MRI-assessed paraspinal muscles' FI on pain or disability 2 years after surgery for LSS. A muscle fat index (MFI) was calculated (by dividing signal intensity of psoas to multifidus and erector spinae) on preoperative axial T2-weighted MRI of patients with LSS. Pain and disability 2 years after surgery were assessed using the Oswestry disability index, the Zurich claudication questionnaire and numeric rating scales for leg and back pain. Multivariate linear and logistic regression analyses (adjusted for preoperative outcome scores, age, body mass index, sex, smoking status, grade of spinal stenosis, disc degeneration and facet joint osteoarthritis) were used to assess the associations between MFI and patient-reported clinical outcomes. In the logistic regression models, odds ratios (OR) and 95% confidence intervals (CI) were calculated for associations between the MFI and ≥ 30% improvement of the outcomes (dichotomised into yes/no). A total of 243 patients were evaluated (mean age 66.6 ± 8.5 years), 49% females (119). Preoperative MFI and postoperative leg pain were significantly associated, both with leg pain as continuous (coefficient - 3.20, 95% CI - 5.61, - 0.80) and dichotomised (OR 1.51, 95% CI 1.17, 1.95) scores. Associations between the MFI and the other outcome measures were not statistically significant. Preoperative FI of the paraspinal muscles on MRI showed statistically significant association with postoperative NRS leg pain but not with ODI or ZCQ.
Identifiants
pubmed: 38528161
doi: 10.1007/s00586-024-08210-z
pii: 10.1007/s00586-024-08210-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Helse Midt-Norge
ID : 2013/10174
Organisme : Sophies Minde Ortopedi
ID : 02/2019
Informations de copyright
© 2024. The Author(s).
Références
Machado GC, Ferreira PH, Yoo RI, Harris IA, Pinheiro MB, Koes BW, van Tulder MW, Rzewuska M, Maher CG, Ferreira ML (2016) Surgical options for lumbar spinal stenosis. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.Cd012421
doi: 10.1002/14651858.Cd012421
pubmed: 27801521
pmcid: 6464992
Zaina F, Tomkins-Lane C, Carragee E, Negrini S (2016) Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD010264.pub2
doi: 10.1002/14651858.CD010264.pub2
pubmed: 26824399
pmcid: 6669253
Lurie J, Tomkins-Lane C (2016) Management of lumbar spinal stenosis. BMJ 352:h6234. https://doi.org/10.1136/bmj.h6234
doi: 10.1136/bmj.h6234
pubmed: 26727925
pmcid: 6887476
Pearson A, Blood E, Lurie J, Abdu W, Sengupta D, Frymoyer JW, Weinstein J (2011) Predominant leg pain is associated with better surgical outcomes in degenerative spondylolisthesis and spinal stenosis: results from the Spine Patient Outcomes Research Trial (SPORT). Spine 36:219–229. https://doi.org/10.1097/BRS.0b013e3181d77c21
doi: 10.1097/BRS.0b013e3181d77c21
pubmed: 21124260
pmcid: 3057763
Aalto TJ, Malmivaara A, Kovacs F, Herno A, Alen M, Salmi L, Kröger H, Andrade J, Jiménez R, Tapaninaho A, Turunen V, Savolainen S, Airaksinen O (2006) Preoperative predictors for postoperative clinical outcome in lumbar spinal stenosis: systematic review. Spine 31:E648-663. https://doi.org/10.1097/01.brs.0000231727.88477.da
doi: 10.1097/01.brs.0000231727.88477.da
pubmed: 16915081
Tuomainen I, Pesonen J, Rade M, Pakarinen M, Leinonen V, Kröger H, Airaksinen O, Aalto T (2020) Preoperative predictors of better long-term functional ability and decreased pain following LSS surgery: a prospective observational study with a 10-year follow-up period. Spine 45:776–783. https://doi.org/10.1097/brs.0000000000003374
doi: 10.1097/brs.0000000000003374
pubmed: 31923129
Jermy JE, Copley PC, Poon MTC, Demetriades AK (2020) Does pre-operative multifidus morphology on MRI predict clinical outcomes in adults following surgical treatment for degenerative lumbar spine disease? A systematic review. Eur Spine J 29:1318–1327. https://doi.org/10.1007/s00586-020-06423-6
doi: 10.1007/s00586-020-06423-6
pubmed: 32328791
Aaen J, Banitalebi H, Austevoll IM, Hellum C, Storheim K, Myklebust T, Anvar M, Weber C, Solberg T, Grundnes O, Brisby H, Indrekvam K, Hermansen E (2022) The association between preoperative MRI findings and clinical improvement in patients included in the NORDSTEN spinal stenosis trial. Eur Spine J. https://doi.org/10.1007/s00586-022-07317-5
doi: 10.1007/s00586-022-07317-5
pubmed: 35930062
Gengyu H, Jinyue D, Chunjie G, Bo Z, Yu J, Jiaming L, Weishi L (2022) The predictive value of preoperative paraspinal muscle morphometry on complications after lumbar surgery: a systematic review. Eur Spine J 31:364–379. https://doi.org/10.1007/s00586-021-07052-3
doi: 10.1007/s00586-021-07052-3
pubmed: 34773148
Storheim K, Berg L, Hellum C, Gjertsen O, Neckelmann G, Espeland A, Keller A, Norwegian Spine Study G (2017) Fat in the lumbar multifidus muscles - predictive value and change following disc prosthesis surgery and multidisciplinary rehabilitation in patients with chronic low back pain and degenerative disc: 2-year follow-up of a randomized trial. BMC Musculoskelet Disord 18:145. https://doi.org/10.1186/s12891-017-1505-5
doi: 10.1186/s12891-017-1505-5
pubmed: 28376754
pmcid: 5381060
Marchand A-A, Houle M, O’Shaughnessy J, Châtillon C-É, Cantin V, Descarreaux M (2021) Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial. Sci Rep 11:11080–11080. https://doi.org/10.1038/s41598-021-90537-4
doi: 10.1038/s41598-021-90537-4
pubmed: 34040109
pmcid: 8155114
Ranger TA, Cicuttini FM, Jensen TS, Peiris WL, Hussain SM, Fairley J, Urquhart DM (2017) Are the size and composition of the paraspinal muscles associated with low back pain? A systematic review. Spine J 17:1729–1748. https://doi.org/10.1016/j.spinee.2017.07.002
doi: 10.1016/j.spinee.2017.07.002
pubmed: 28756299
Cooley JR, Walker BF, Ardakani EM, Kjaer P, Jensen TS, Hebert JJ (2018) Relationships between paraspinal muscle morphology and neurocompressive conditions of the lumbar spine: a systematic review with meta-analysis. BMC Musculoskelet Disord 19:351. https://doi.org/10.1186/s12891-018-2266-5
doi: 10.1186/s12891-018-2266-5
pubmed: 30261870
pmcid: 6161433
Betz M, Burgstaller JM, Held U, Andreisek G, Steurer J, Porchet F, Farshad M (2017) Influence of paravertebral muscle quality on treatment efficacy of epidural steroid infiltration or surgical decompression in lumbar spinal stenosis-analysis of the lumbar spinal outcome study (LSOS) data: a swiss prospective multicenter cohort study. Spine 42:1792–1798. https://doi.org/10.1097/brs.0000000000002233
doi: 10.1097/brs.0000000000002233
pubmed: 28542102
Cook DA, Beckman TJ (2006) Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med 119:166.e167–116. https://doi.org/10.1016/j.amjmed.2005.10.036
doi: 10.1016/j.amjmed.2005.10.036
Banitalebi H, Aaen J, Storheim K, Negård A, Myklebust T, Grotle M, Hellum C, Espeland A, Anvar M, Indrekvam K, Weber C, Brox JI, Brisby H, Hermansen E (2022) A novel MRI index for paraspinal muscle fatty infiltration: reliability and relation to pain and disability in lumbar spinal stenosis: results from a multicentre study. Eur Radiol Exp 6:38. https://doi.org/10.1186/s41747-022-00284-y
doi: 10.1186/s41747-022-00284-y
pubmed: 35854201
pmcid: 9296716
Hermansen E, Austevoll IM, Romild UK, Rekeland F, Solberg T, Storheim K, Grundnes O, Aaen J, Brox JI, Hellum C, Indrekvam K (2017) Study-protocol for a randomized controlled trial comparing clinical and radiological results after three different posterior decompression techniques for lumbar spinal stenosis: the Spinal Stenosis Trial (SST) (part of the NORDSTEN Study). BMC Musculoskelet Disord 18:121. https://doi.org/10.1186/s12891-017-1491-7
doi: 10.1186/s12891-017-1491-7
pubmed: 28327114
pmcid: 5361830
Hermansen E, Austevoll IM, Hellum C, Storheim K, Myklebust T, Aaen J, Banitalebi H, Anvar M, Rekeland F, Brox JI, Franssen E, Weber C, Solberg TK, Furunes H, Grundnes O, Brisby H, Indrekvam K (2022) Comparison of 3 different minimally invasive surgical techniques for lumbar spinal stenosis: a randomized clinical trial. JAMA Netw Open 5:e224291. https://doi.org/10.1001/jamanetworkopen.2022.4291
doi: 10.1001/jamanetworkopen.2022.4291
pubmed: 35344046
pmcid: 8961320
Fortin M, Lazáry À, Varga PP, Battié MC (2017) Association between paraspinal muscle morphology, clinical symptoms and functional status in patients with lumbar spinal stenosis. Eur Spine J 26:2543–2551. https://doi.org/10.1007/s00586-017-5228-y
doi: 10.1007/s00586-017-5228-y
pubmed: 28748488
Schizas C, Theumann N, Burn A, Tansey R, Wardlaw D, Smith FW, Kulik G (2010) Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine 35:1919–1924. https://doi.org/10.1097/BRS.0b013e3181d359bd
doi: 10.1097/BRS.0b013e3181d359bd
pubmed: 20671589
Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878. https://doi.org/10.1097/00007632-200109010-00011
doi: 10.1097/00007632-200109010-00011
pubmed: 11568697
Weishaupt D, Zanetti M, Boos N, Hodler J (1999) MR imaging and CT in osteoarthritis of the lumbar facet joints. Skeletal Radiol 28:215–219. https://doi.org/10.1007/s002560050503
doi: 10.1007/s002560050503
pubmed: 10384992
Austevoll IM, Hermansen E, Fagerland MW, Storheim K, Brox JI, Solberg T, Rekeland F, Franssen E, Weber C, Brisby H, Grundnes O, Algaard KRH, Böker T, Banitalebi H, Indrekvam K, Hellum C (2021) Decompression with or without fusion in degenerative lumbar spondylolisthesis. N Engl J Med 385:526–538. https://doi.org/10.1056/NEJMoa2100990
doi: 10.1056/NEJMoa2100990
pubmed: 34347953
Turner EL, Dobson JE, Pocock SJ (2010) Categorisation of continuous risk factors in epidemiological publications: a survey of current practice. Epidemiol Persp Innov 7:9. https://doi.org/10.1186/1742-5573-7-9
doi: 10.1186/1742-5573-7-9
Yu B, Jiang K, Li X, Zhang J, Liu Z (2017) Correlation of the features of the lumbar multifidus muscle with facet joint osteoarthritis. Orthopedics 40:e793–e800. https://doi.org/10.3928/01477447-20170531-05
doi: 10.3928/01477447-20170531-05
pubmed: 28585998
Han G, Zou D, Li X, Zhang S, Li Z, Zhou S, Li W, Sun Z, Li W (2022) Can fat infiltration in the multifidus muscle be a predictor of postoperative symptoms and complications in patients undergoing lumbar fusion for degenerative lumbar spinal stenosis? A case-control study. J Orthop Surg Res 17:289. https://doi.org/10.1186/s13018-022-03186-2
doi: 10.1186/s13018-022-03186-2
pubmed: 35619169
pmcid: 9137055
Liu Y, Liu Y, Hai Y, Liu T, Guan L, Chen X (2019) Fat infiltration in the multifidus muscle as a predictor of prognosis after decompression and fusion in patients with single-segment degenerative lumbar spinal stenosis: an ambispective cohort study based on propensity score matching. World Neurosurg 128:e989–e1001. https://doi.org/10.1016/j.wneu.2019.05.055
doi: 10.1016/j.wneu.2019.05.055
pubmed: 31100519
Genevay S, Atlas SJ (2010) Lumbar spinal stenosis. Best Pract Res Clin Rheumatol 24:253–265. https://doi.org/10.1016/j.berh.2009.11.001
doi: 10.1016/j.berh.2009.11.001
pubmed: 20227646
pmcid: 2841052
Bogduk N (1980) Lumbar dorsal ramus syndrome. Med J Aust 2:537–541. https://doi.org/10.5694/j.1326-5377.1980.tb100759.x
doi: 10.5694/j.1326-5377.1980.tb100759.x
pubmed: 6450875
Jin Q, Chang Y, Lu C, Chen L, Wang Y (2023) Referred pain: characteristics, possible mechanisms, and clinical management. Front Neurol 14:1104817. https://doi.org/10.3389/fneur.2023.1104817
doi: 10.3389/fneur.2023.1104817
pubmed: 37448749
pmcid: 10338069
Hébert JJ, Abraham E, Wedderkopp N, Bigney E, Richardson E, Darling M, Hall H, Fisher CG, Rampersaud YR, Thomas KC, Jacobs WB, Johnson M, Paquet J, Attabib N, Jarzem P, Wai EK, Rasoulinejad P, Ahn H, Nataraj A, Stratton A, Manson N (2020) Preoperative factors predict postoperative trajectories of pain and disability following surgery for degenerative lumbar spinal stenosis. Spine 45:E1421-e1430. https://doi.org/10.1097/brs.0000000000003587
doi: 10.1097/brs.0000000000003587
pubmed: 32541610
pmcid: 7547903
Storheim K, Holm I, Gunderson R, Brox JI, Bø K (2003) The effect of comprehensive group training on cross-sectional area, density, and strength of paraspinal muscles in patients sick-listed for subacute low back pain. J Spinal Disord Tech 16:271–279. https://doi.org/10.1097/00024720-200306000-00008
doi: 10.1097/00024720-200306000-00008
pubmed: 12792342
Reinders I, Murphy RA, Koster A, Brouwer IA, Visser M, Garcia ME, Launer LJ, Siggeirsdottir K, Eiriksdottir G, Jonsson PV, Gudnason V, Harris TB (2015) Muscle quality and muscle fat infiltration in relation to incident mobility disability and gait speed decline: the age, gene/environment susceptibility-reykjavik study. J Gerontol A Biol Sci Med Sci 70:1030–1036. https://doi.org/10.1093/gerona/glv016
doi: 10.1093/gerona/glv016
pubmed: 25748031
pmcid: 4506318
Andreisek G, Imhof M, Wertli M, Winklhofer S, Pfirrmann CW, Hodler J, Steurer J (2013) A systematic review of semiquantitative and qualitative radiologic criteria for the diagnosis of lumbar spinal stenosis. AJR Am J Roentgenol 201:W735-746. https://doi.org/10.2214/ajr.12.10163
doi: 10.2214/ajr.12.10163
pubmed: 24147503
Crawford RJ, Filli L, Elliott JM, Nanz D, Fischer MA, Marcon M, Ulbrich EJ (2016) Age- and level-dependence of fatty infiltration in lumbar paravertebral muscles of healthy volunteers. Am J Neuroradiol 37:742. https://doi.org/10.3174/ajnr.A4596
doi: 10.3174/ajnr.A4596
pubmed: 26635285
pmcid: 7960169
Andersen T, Christensen FB, Laursen M, Høy K, Hansen ES, Bünger C (2001) Smoking as a predictor of negative outcome in lumbar spinal fusion. Spine 26:2623–2628. https://doi.org/10.1097/00007632-200112010-00018
doi: 10.1097/00007632-200112010-00018
pubmed: 11725245
Han G, Jiang Y, Zhang B, Gong C, Li W (2021) Imaging evaluation of fat infiltration in paraspinal muscles on MRI: a systematic review with a focus on methodology. Orthop Surg 13:1141–1148. https://doi.org/10.1111/os.12962
doi: 10.1111/os.12962
pubmed: 33942525
pmcid: 8274185