Paraspinal Muscles Research Articles

Implication of Bone Mineral Density and Body Composition Parameters for Length of Hospital Stay in Patients with COVID-19.

Multisystem information, including musculoskeletal information, can be captured from chest CT scans of patients with COVID-19 without further examination. This study aims to assess the relationship between chest CT-extracted baseline bone mineral density (BMD) and body composition parameters and the length of hospital stay in these patients. A retrospective analysis was performed in a cohort of 88 patients with COVID-19. Correlation analysis and a generalized linear model (GLM) were used to assess the associations between the length of hospital stay and covariates, including age, sex, body mass index (BMI), BMD and body composition variables. The mean length of hospital stay was 27.4±8.7 days. The length of hospital stay was significantly positively associated with age (r=0.202, p=0.046) and the paraspinal muscle fat ratio (r=0.246, p=0.021). The GLM involving age, sex, BMD, paraspinal muscle fat ratio, subcutaneous adipose tissue (SAT) area, visceral adipose tissue (VAT) area, and liver fat fraction (LFF) showed that the length of hospital stay was positively correlated with VAT area (β coefficients, 95% CI: 9.304, 1.141-17.478, p=0.025). The musculoskeletal features extracted from chest CT correlated with the prognosis of COVID-19 patients. Factors including old age, a higher paraspinal muscle fat ratio and a larger VAT area in patients with COVID-19 were associated with longer hospital stays.

The relationship between structural changes in paraspinal muscles and intervertebral disc and facet joint degeneration in the lumbar spine of rats

BackgroundDegenerative spine disease is one of the largest causes of disability worldwide and has a multifactorial aetiology. Determining the leading causes of this multifactorial disease could help create new treatment approaches.PurposeStudy the impact of degenerative changes in the paraspinal muscles caused by local (prolonged compression) or systemic (high-fat diet) factors on the structure of the intervertebral discs (IVDs) and facet joints of the lumbar spine in rats.MethodsThe study was conducted using two animal models to create degenerative changes in the paraspinal muscles of 10 white laboratory rats for 90 days and five control rats: 1) high-fat diet model (model 1) involved keeping the rats on a high calorie diet; 2) compression model (model 2) involved binding the paraspinal muscles from L2 to S1 using non-absorbable sutures. Histological analysis for the facet joints and IVDs of rats (at the L1–L4 level) with semi-quantitative analysis of the structure conducted used by degeneration grading system for IVDs and cartilage degeneration score (OARSI) for facet joint.ResultsIn both models, 90 days after the experiment, the degenerative changes observed in the rats’ IVDs were more severe in the annulus fibrosus than in the nucleus pulposus. The height of the IVD in model 1 did not differ from the control group, but in the model 2 was 1.3 times greater (p < 0.001) compared with control. Degenerative changes in the IVD were scored out 5.3 ± 1.7 in model 1 and 5.32 ± 2.1 in model 2 of a possible 16. The height of the articular cartilage of the facet joints was smaller by 1.5 times (p < 0.001) and 1.4 times (p < 0.001) in model 1 and model 2, respectively, compared to the control. Degenerative changes of facet joint were scored out 3.7 ± 0.6 in model 1 and 3.8 ± 0.6 in model 2 of five points according to the cartilage degeneration score.ConclusionsIt was determined that rats who had structural changes in the lumbar paraspinal muscles as a result of being kept on a high-fat diet or subjected to prolonged compression for 90 days, showed degenerative changes in intervertebral discs and osteoarthritis in facet joints of lumbar spine.

Ayurvedic Panchakarma Management of Avabahuka - A Case Report

Background: Avabahuka is the disease of Amsa Sandhi (shoulder joint), which involves the neuromuscular system. The clinical features of Avabahuka are pain, stiffness, and restricted shoulder joint movement. In this study, Sahachar (Barleria prionitis Linn.) Taila was used for Snehana, and Patra Pottali (Ayurvedic Herbal Bolus) was used for Swedana containing leaves of medicinal plants. Aim and objective: To evaluate the efficacy of Snehana and Patra Pottali Swedana, along with Shamana Aushadhi in Avabahuka. Material and methods: A male patient, 40 years old, was diagnosed with an Avabahuka from a clinical point of view. There was a painful, restricted movement of the right shoulder joint radiating to the right elbow joint. X-ray of cervical region AP and lateral view shows mild straightening of cervical lordosis due to paraspinal muscle spasm and C5 – C6 disc space narrowing. He was treated with Panchakarma Snehana and Patra Pottali Swedana followed by Shamana Chikitsa for 7 days and follow-up after 14 days. Result: The patient was assessed with subjective and objective parameters. The scores of pain turned to reduced 3 to 1, stiffness 3 to 0, and range of movement; flexion 1300 to 1600, extension 500 to 600, abduction 1250 to 1450, adduction 350 to 550, internal rotation 700 to 850, and external rotation 800 to 900. Significant changes and improvements were observed in the clinical features of Avabahuka before and after treatment. Conclusion: The present study shows Ayurveda has better management for Avabahuka, which was observed by strategically combining the effects of Panchakarma and Shamana Chikitsa.

Asymmetric expression of PIEZO2 in paraspinal muscles of adolescent idiopathic scoliosis.

Muscle imbalance has long been recognized as one of the possible pathogeneses for adolescent idiopathic scoliosis (AIS). PIEZO2, the susceptibility gene of AIS, has been identified to play an important role in neuromuscular activities. This study aims to compare the mRNA expression of PIEZO2 between concave and convex paraspinal muscles of AIS patients and to identify the relationship between the ratio of PIEZO2 expression and curve magnitude. Twenty female AIS patients (right thoracic curve) who underwent spinal correction surgery were divided into moderate (n= 12) and severe (⩾ 70 degrees) curve groups (n= 8). The morphology of the paraspinal muscles was assessed with spinal MRI. Multifidus specimens were collected during surgical operations from the concave and convex sides of the apical region, and mRNA expression of the PIEZO2 gene was compared between sides. The localization of PIEZO2 protein expression was confirmed with the markers PAX7 and PAX3, and the percentage of PIEZO2+ cells was also investigated. In the moderate curve group, fatty infiltration in the deep paraspinal muscle was significantly higher on the concave side than on the convex side. There were no differences in deep muscle area, superficial muscle area, or fatty infiltration of superficial paraspinal muscle. The mRNA expression of PIEZO2 was significantly increased on the concave side, and the asymmetric expression predominantly occurred in moderate curves rather than severe ones. PIEZO2 was expressed on satellite cells instead of fibers of the muscle spindle. The percent of PIEZO2+PAX7+ cells in myofibers was significantly higher on the concave side in the moderate curve group, but not in the severe curve group. Asymmetric morphological changes occur in the deep paraspinal muscles of AIS. The PIEZO2 is asymmetrically expressed in the multifidus muscle and is preferentially expressed in satellite cells.

Electromyography of paraspinal muscles during self-corrective positions in adolescent idiopathic scoliosis.

Self-corrective exercise is commonly used in the training protocol of patients with adolescent idiopathic scoliosis (AIS). The muscle activation pattern during symmetrical and overcorrection exercises is then explored to guide the treatment. To compare the paraspinal muscle activity during three self-corrective positions and the habitual standing in AIS. Thirty-three adolescents with double curved scoliosis were examined. The curve type and Cobb's angle were determined from their whole spine X-ray. They adopted habitual standing, symmetrical correction and two overcorrected positions (O1 and O2). The surface electromyography (EMG) was monitored on both sides of paraspinal muscles at the apex areas of scoliotic curves. The EMG ratio between sides was inferred as the corrective effect. All three self-correction positions produced greater EMG ratios compared with the habitual standing. The greatest EMG ratios were observed during the O1 position at the thoracic curve and the habitual standing at the lumbar curve. Participants with different subtypes of curves exhibited similar patterns of EMG ratios. From the biomechanical viewpoint, all three self-corrective positions possibly provided therapeutic effects for the scoliotic body regardless of the subtype of scoliosis curves. The O1 position seemed to be most effective for the adjusting activation of thoracic paraspinal muscles. The symmetrical corrective position is otherwise recommended for adjusting the lumbar muscle activation.

Comparative cohort study of paraspinal muscle volume change between uniportal full endoscopic and mini open posterolateral transforaminal lumbar interbody fusion

BackgroundRecent literature of uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion demonstrates good clinical and radiological outcomes with minimally invasive benefits of potentially preserving paraspinal muscle. There is no literature on paraspinal muscle volume change between the endoscopic and microscopic mini open interbody fusion. MethodsWe included patients who met the indication criteria for lumbar fusion and underwent either uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion or open transforaminal lumbar interbody fusion. Clinical parameters of visual analog scale and Oswestry disability index were measured at preoperative, postoperative 1 week, 3 months postoperative and final follow up. Magnetic Resonance Imaging measurement of preoperative and postoperative Kjaer grade, right and left psoas muscle mass area, right and left paraspinal muscle mass area were performed. Results74 levels of Endo-TLIF and 42 patients with mini open TLIF (MIS-TLIF) were included. There was statistically significant greater improvement in VAS and ODI in Endo-TLIF cohort at 1 week significant improvement of Kjaer grade at postoperative 1 year in Endo-TLIF compared to MIS-TLIF. There is statistically significant improvement in paraspinal muscle mass area in Endo-TLIF (104.83 ± 316.45) mm2 compared to MIS-TLIF (89.88 ± 185.14) mm2 ConclusionUniportal Endoscopic Posterolateral Lumbar Transforaminal Interbody Fusion achieved improved paraspinal and psoas muscle bulk and less fatty infiltration in the operated level as compared to mini open Transforaminal Lumbar Interbody Fusion while both cohorts achieved equivalent positive clinical outcomes.

MRI paraspinous skeletal muscle enhancement: A potential imaging biomarker for assessing clinical liver cirrhosis severity.

To evaluate for correlation between MRI paraspinous muscle (PSM) enhancement and clinical measures of cirrhosis severity (CMCS) utilizing established imaging biomarkers of sarcopenia as comparison. Retrospective evaluation of 224 patients (mean age 59.6± 9.7 years, 135 males and 89 females) with liver cirrhosis who underwent contrast-enhanced MRI between August 2021 and August 2022 was performed. Assessed variables included: body mass index (BMI), varices and ascites present on imaging (VPI and API), albumin, total bilirubin (Tbili), international normalized ratio (INR), creatinine, MELD score, as well as history of paracentesis (PH), spontaneous bacterial peritonitis, and variceal bleed (VBH). These variables were compared to PSM skeletal muscle index (SMI), PSM signal fat fractions (sFF), and PSM contrast enhancement fraction (CEFR) calculated on arterial (CEFR-ART), portal venous (CEFR-PV), and delayed (CEFR-DEL) phases collected on MRI. Patients with MELD>17, PH, and VPI had lower PSM CEFR-ART (0.06vs. 0.11, p = 0.01; 0.07vs. 0.11, p = 0.01; and 0.09vs. 0.13, p = 0.03, respectively). PSM CEFR-ART correlated negatively with MELD. Patients with MELD>17 and PH had lower PSM CEFR-PV (0.16vs. 0.23, p = 0.02; 0.18 vs. 0.23, p = 0.01, respectively). PSM CEFR-PV correlated positively with albumin and negatively with Tbili, INR, and MELD. PSM CEFR-DEL correlated negatively with Tbili and MELD. Patients with API, PH, and VBH had lower PSM SMI (4.68vs. 5.59, p<0.001; 4.37vs. 5.48, p<0.001; 4.78vs. 5.35, p = 0.04, respectively). PSM SMI correlated negatively with Tbili and positively with BMI. PSM sFF correlated positively with BMI, PSM CEFR-PV, and PSM CEFR-DEL. PSM CEFR is significantly reduced on MRI in patients with clinical manifestations of severe liver cirrhosis. Further investigation into PSM CEFR's usefulness as an imaging biomarker for evaluating liver disease severity is warranted.

Evaluation of the relationship between the severity of sarcopenia and osteoporosis: A magnetic resonance imaging and dual-energy X-ray absorptiometry study

This study aimed to investigate the presence of sarcopenia which was graded according to Magnetic Resonance (MR) imaging in paraspinal muscles and explore the degree of osteoporosis by bone mineral density. Lumber MR images of 69 female patients complaining of back pain and Dual-Energy X-ray absorptiometry (DXA) examinations were evaluated retrospectively. On MR imaging, the degree of sarcopenia in the paraspinal muscles of these patients was graded as normal, moderate and severe according to the simplified 3-Tier classification which is considered a Modified Goutallier classification by two radiologists. DXA examinations were categorized based on the t-score, with scores above -2.5 denoting osteopenia and scores below -2.5 indicating osteoporosis. Grades of atrophy in paraspinal muscles were found to be normal (n=15, 21.7%), moderate (n=43, 62.3%) and severe (n=11, 15.9%). The degree of paraspinal muscle atrophy was found to be lower in patients with osteopenia compared to patients with osteoporosis by both observers. (Radiologist 1 p: 0.284, radiologist 2 p: 0.047). As the degree of atrophy in the paraspinal muscles increases, the DXA t score decreases in some osteoporotic patients. Paraspinal muscle atrophy detected on lumbar MRI and DXA T scores are correlated in patients with low back pain. Identifying pathways affecting both bone and muscle units will facilitate developmental entities aiming to treat both conditions.

Nomogram Development and Validation for Predicting Postoperative Recurrent Lumbar Disc Herniation Based on Paraspinal Muscle Parameters.

Previous studies highlight paraspinal muscles' significance in spinal stability. This study aims to assess paraspinal muscle predictiveness for postoperative recurrent lumbar disc herniation (PRLDH) after lumbar disc herniation patients undergo percutaneous endoscopic transforaminal discectomy (PETD). Retrospectively collected data from 232 patients undergoing PETD treatment at our institution between January 2020 and January 2023, randomly allocated into training (60%) and validation (40%) groups. Utilizing Lasso regression and multivariable logistic regression, independent risk factors were identified in the training set to construct a Nomogram model. Internal validation employed Enhanced Bootstrap, with Area Under the ROC Curve (AUC) assessing accuracy. Calibration was evaluated through calibration curves and the Hosmer-Lemeshow goodness-of-fit test. Decision curve analysis (DCA) and clinical impact curve (CIC) were employed for clinical utility analysis. Diabetes, Modic changes, and ipsilesional multifidus muscle skeletal muscle index (SMI) were independent predictive factors for PRLDH following PETD (P<0.05). Developed Nomogram model based on selected predictors, uploaded to a web page. AUC for training: 0.921 (95% CI 0.872-0.970), validation: 0.900 (95% CI 0.828-0.972), respectively. The Hosmer-Lemeshow test yielded χ 2=5.638/6.259, P=0.688/0.618, and calibration curves exhibited good fit between observed and predicted values. DCA and CIC demonstrate clinical net benefit for both models at risk thresholds of 0.02-1.00 and 0.02-0.80. The Nomogram predictive model developed based on paraspinal muscle parameters in this study demonstrates excellent predictive capability and aids in personalized risk assessment for PRLDH following PETD.

The assessment of paraspinal muscle epimuscular fat in participants with and without low back pain: A case-control study

It remains unclear whether paraspinal muscle fatty infiltration in low back pain (LBP) is i) solely intramuscular, ii) is lying outside the epimysium between the muscle and fascial plane (epimuscular) or iii) or combination of both, as imaging studies often use different segmentation protocols that are not thoroughly described. Epimuscular fat possibly disturbs force generation of paraspinal muscles, but is seldomly explored. This project aimed to 1) compare epimuscular fat in participants with and without chronic LBP, and 2) determine whether epimuscular fat is different across lumbar spinal levels and associated with BMI, age, sex and LBP status, duration or intensity. Fat and water lumbosacral MRIs of 50 chronic LBP participants and 41 healthy controls were used. The presence and extent of epimuscular fat for the paraspinal muscle group (erector spinae and multifidus) was assessed using a qualitative score (0–5 scale; 0 = no epimuscular fat and 5 = epimuscular fat present along the entire muscle) and quantitative manual segmentation method. Chi-squared tests evaluated associations between qualitative epimuscular fat ratings and LBP status at each lumbar level. Bivariate and partial spearman’s rho correlation assessed relationships between quantitative and qualitative epimuscular fat with participants’ characteristics. Epimuscular fat was more frequent at the L4-L5 (X2 = 13.781, p = 0.017) and L5-S1 level (X2 = 27.825, p < 0.001) in participants with LBP compared to controls, which was not found for the higher lumbar levels. The total qualitative score (combined from all levels) showed a significant positive correlation with BMI, age, sex (female) and LBP status (r = 0.23–0.55; p < 0.05). Similarly, the total area of epimuscular fat (quantitative measure) was significantly correlated with BMI, age and LBP status (r = 0.26–0.57; p < 0.05). No correlations were found between epimuscular fat and LBP duration or intensity. Paraspinal muscle epimuscular fat is more common in chronic LBP patients. The functional implications of epimuscular fat should be further explored.

Association of Preoperative Osteoporotic Vertebral Compression Fractures with Muscle Atrophy in Lumbar Spinal Stenosis: A Retrospective Cohort Study.

Osteoporotic vertebral compression fractures (OVCFs) are common in older individuals and lead to pain, spinal deformities, and limited mobility. Paraspinal muscle function correlates with fracture severity, and this association may be more significant in patients with lumbar spinal stenosis (LSS). However, studies on the effects of OVCFs are lacking. This study aimed to investigate the relationship between OVCFs, fat infiltration, and muscle atrophy in patients with LSS. This study included 177 patients with preoperative LSS, of whom 16 had OVCFs and 161 did not. Lumbar lordosis angle, fat infiltration, and paraspinal muscle atrophy were evaluated in these patients. Information on patient characteristics such as smoking, diabetes, hemodialysis, steroid use, American Society of Anesthesiologists score, and bladder or bowel dysfunction were obtained from medical records. Logistic regression analysis was conducted to identify factors independently associated with OVCF. Patients in the OVCF group were significantly older (P=0.006) than those without fractures, and a higher proportion of the OVCF group showed muscle atrophy (P=0.034). Significant variables and those with moderate effect sizes were included in the logistic regression analysis. Muscle atrophy (P=0.028) was independently associated with OVCF. Muscle atrophy was associated with preoperative OVCFs in patients with LSS. Identifying OVCFs in these patients may underscore the importance of tailored treatment and rehabilitation strategies for the paraspinal muscles.

Clinical and genetic characterisation of hereditary distal myopathies in a series of Colombian patients

Hereditary distal myopathies represent a heterogeneous group of rare genetic disorders characterized by progressive distal muscle weakness. The objective of this study was to describe the clinical spectrum and genetic findings in a series of patients with distal myopathy from Colombia. A retrospective review of the medical records of 12 patients with distal myopathy seen at a neuromuscular center in Bogota, Colombia, between 2015 and 2023 was performed. Clinical data, family history, diagnostic studies and genetic test results were obtained. The mean age of onset was 15.7 years. Patterns of limb weakness included distal involvement in the upper and lower extremities (50%), distal involvement in the lower extremities in isolation (33.3%), and proximal and distal involvement in the upper and lower extremities (8.3%). Additional weakness was observed in the face (8.3%) and paraspinal muscles (25.0%). Creatine kinase levels were elevated in 58.3% of cases. Electromyography revealed a myopathic pattern in 91.6% of cases. Variants identified included MYH7, ANO5, TTN, HNRNPA1, DES, DYSF and CAV3 genes. This case series describes the clinical and genetic spectrum of inherited distal myopathies in Colombia. Findings demonstrate phenotypic and genotypic heterogeneity, with variants in genes encoding structural proteins. There is a need to expand access to genetic testing in Latin America to enable more accurate comprehensive diagnosis and treatment.

Scoliosis as a clinical and social problem: case study

This is a case study of a 7-year-old boy with thoracolumbar scoliosis. An examination revealed trunk, shoulder and scapular asymmetry, pelvic obliquity, head and shoulder protraction, and reduced flexibility of the paraspinal and pelvic muscles. The child underwent a 1-year rehabilitation programme according to the Functional Individual Therapy of Scoliosis (FITS) method and three-plane manual therapy of foot defects as well as scoliotic curve correction with asymmetric exercises and the use of Thera-Band. After one year of rehabilitation, a physical and radiographic examination showed a considerable reduction in the Cobb angle as well as the angle of trunk rotation. Regular scoliosis screening should be offered to children and adolescents in kindergartens and schools.

Short term use of balance pads on postural sway and musculus multifidus cross sectional area in horses

Horses with musculoskeletal injuries have poor postural stability with larger center of mass (COM) movements and asymmetry/atrophy of the musculus (m.) multifidus. The objective of this study was to determine the effect of balance pad use in horses on both COM motions and m. multifidus cross sectional area (CSA). We hypothesized that use of balance pads would decrease COM motions and increase m. multifidus CSA and symmetry. Six healthy adult horses stood on balance pads for 5 min twice daily, 5 days per week for 4 weeks. At baseline and study completion, COM motion was determined using a portable media device, with horse standing on and off balance pads. Ultrasound of m. multifidus was performed bilaterally at select thoracic (T) and lumbar (L) vertebra: T12, T14, T16, T18, L2, and L5. Data were analyzed using mixed-model ANOVA. At baseline, there was significantly more medial-lateral and cranio-caudal motion when horses stood on pads compared to square stance (P < 0.006). When standing on pads, there was a significant decrease in motion at 4 weeks compared to baseline (P < 0.0004). There was a significant increase in m. multifidus CSA at T14 at 4 weeks compared to baseline (P = 0.021). When comparing baseline and 4 weeks CSA, there was no significant difference in m. multifidus asymmetry. These results suggest that implementation of balance pads for 4 weeks can improve postural stability in horses and increase CSA at T14. Longer duration of use may be needed for additional changes to paraspinal musculature.

Relationship between the postoperative variations of paraspinal muscles and adjacent-segment degeneration in patients with degenerative lumbar spinal stenosis after posterior instrumented lumbar fusion.

This study aimed to quantify pre- and postoperative paraspinal muscular variation following posterior lumbar interbody fusion (PLIF) in patients with degenerative lumbar spinal stenosis (DLSS) and measure the association of this variation with adjacent-segment degeneration (ASD). Data from 149 patients who underwent L4-S1 PLIF for DLSS were collected. Patients were divided into radiologically confirmed ASD and control groups according to follow-up radiological findings. MRI was performed before surgery and at the last follow-up. Muscular parameters including the relative cross-sectional area (rCSA), relative functional cross-sectional area (rFCSA), relative total cross-sectional area (rTCSA), and fatty infiltration (FI) of the multifidus (MF), erector spinae (ES), and psoas major (PM) muscles were measured on preoperative and follow-up L2-S1 MR images. Logistic regression was used to investigate risk factors for ASD. The rate of radiological ASD was 42.3% at the final follow-up (mean 25.71 ± 8.35 months). At surgical levels, the rFCSA and rTCSA of the MF and ES muscles decreased. The FI of the MF from L2-3 to L5-S1 and ES muscles at L5-S1 significantly increased after surgery, while the rFCSA and rTCSA of the PM muscle increased and its FI decreased. At adjacent levels, the rFCSA and rTCSA of the MF muscle and rTCSA of the ES muscle decreased and the FI of the MF muscle increased postoperatively (p < 0.05), but the rFCSA and rTCSA of the PM muscle increased and its FI decreased (p < 0.05). The FIs of the MF, ES, and PM muscles at adjacent levels significantly differed between the ASD and control groups. Logistic regression analysis indicated that higher BMI (p = 0.002) and FI of the PM muscle at adjacent levels (p = 0.025) were significant risk factors for ASD. The functional area decreased in the MF and ES muscles and increased in the PM muscle after L4-S1 PLIF. A compensatory postoperative decrease in FI of the PM muscle at the adjacent level was a protective factor for ASD in DLSS patients after PLIF.

Pathological Spontaneous Activity in Different Thoracic Paraspinal Muscles in Amyotrophic Lateral Sclerosis

Objective: The aim of our study was to compare the clinical value of pathological spontaneous activity (PSA) in different thoracic paraspinal muscles (TPMs) in amyotrophic lateral sclerosis (ALS).Methods: A total of 116 ALS patients were retrospectively analyzed over 31 ± 8 months concerning the occurrence of PSA in T9–T11 TPM. The occurrence of PSA was correlated with pulmonary function and clinical disability.Results: The positive sharp wave (PSW) potentials were more frequently observed than fibrillation (fib) in T9–T11 segments. The PSA positive frequency of bulbar‐onset ALS (B‐ALS) is less than upper limb‐onset ALS (U‐ALS) and lower limb‐onset ALS (L‐ALS) at the levels of T10 and T11 TPM (p = 0.050, p = 0.001). The fibs/PSWs in TPM indicated high sensitivity and negative predictive value for forced vital capacity (FVC) &lt; 80%. Linear correlation analysis indicated that PSA of TPM was associated with pulmonary ventilation function (PVF). Associations also exist between clinical parameters and PVF as well as the disease severity.Conclusions: The occurrence of T9‐TPM fibs/PSWs was correlated with clinical disability and is extremely helpful in implying an involvement of PVF. The T9‐TPM typically provided a good practical indicator for comprehensive disease evaluation, which was irrelevant to the site of onset.

Prediction of proximal junctional kyphosis after corrective surgery for adult spine deformity: An MRI-based model combining bone and paraspinal muscle quality metrics

Prediction of proximal junctional kyphosis after corrective surgery for adult spine deformity: An MRI-based model combining bone and paraspinal muscle quality metrics

Is trans-sacral endoscopic laser decompression truly effective? Clinical and functional assessment of a single spine center.

Herniated nucleus pulposus (HNP), without causing significant neurological deficit, is a more frequently occurring disease of the spine affecting the activities of daily living with chronic back pain and sometimes progressing to produce significant functional deficit. Trans-sacral epiduroscopic laser decompression (SELD) is being increasingly used as a treatment modality for these conditions and has been shown to give effective results. We present the clinical outcomes of the patients undergoing SELD in our institute for HNP. A retrospective study of 411 patients who underwent SELD for lumbar disc herniation was done, analyzing the clinical outcomes by measuring visual analog scale (VAS) scores for leg pain and back pain, Oswestry Disability Index (ODI) score, and Short form health survey (SF -36) scores and followed up for 6 months. A total of 195 males and 216 females underwent SELD, with a mean age of 33.2 ± 0.9 years and a mean follow-up period of 7 ± 1.6 months. VAS scores for back pain and leg pain improved significantly from 6.9 ± 0.5 and 6.6 ± 0.6 preoperatively to 1.1 ± 0.5 (P > 0.05) and 0.4 ± 0.5 (P > 0.05) at 6 months. ODI score decreased from 28.2 ± 1.7 to 9.4 ± 1.7 at 6 months from the intervention (P < 0.05). SF-36 showed significant improvement in overall categories through 6 months of follow-up. Twenty-four patients had dural punctures, and four patients needed blood patches but recovered without any complications. One patient had aggravation of the disc herniation post-procedure, and was managed by endoscopic discectomy. SELD is a safe, accurate, and effective procedure in treating symptomatic lumbar disc herniation with excellent clinical outcomes and effective pain relief with minimal damage to paraspinal muscles with an easier learning curve, reproducible results, and high safety index.

Relationship between posterior paraspinal muscle fat infiltration and early conversion to lumbar spinal fusion following decompression surgery

Relationship between posterior paraspinal muscle fat infiltration and early conversion to lumbar spinal fusion following decompression surgery

Predicted vs. measured paraspinal muscle activity in adolescent idiopathic scoliosis patients: EMG validation of optimization-based musculoskeletal simulations

Musculoskeletal (MSK) models offer great potential for predicting the muscle forces required to inform more detailed simulations of vertebral endplate loading in adolescent idiopathic scoliosis (AIS). In this work, simulations based on static optimization were compared with in vivo measurements in two AIS patients to determine whether computational approaches alone are sufficient for accurate prediction of paraspinal muscle activity during functional activities.We used biplanar radiographs and marker-based motion capture, ground reaction force, and electromyography (EMG) data from two patients with mild and moderate thoracolumbar AIS (Cobb angles: 21° and 45°, respectively) during standing while holding two weights in front (reference position), walking, running, and object lifting. Using a fully automated approach, 3D spinal shape was extracted from the radiographs. Geometrically personalized OpenSim-based MSK models were created by deforming the spine of pre-scaled full-body models of children/adolescents. Simulations were performed using an experimentally controlled backward approach. Differences between model predictions and EMG measurements of paraspinal muscle activity (both expressed as a percentage of the reference position values) at three different locations around the scoliotic main curve were quantified by root mean square error (RMSE) and cross-correlation (XCorr).Predicted and measured muscle activity correlated best for mild AIS during object lifting (XCorr’s ≥ 0.97), with relatively low RMSE values. For moderate AIS as well as the walking and running activities, agreement was lower, with XCorr reaching values of 0.51 and comparably high RMSE values.This study demonstrates that static optimization alone seems not appropriate for predicting muscle activity in AIS patients, particularly in those with more than mild deformations as well as when performing upright activities such as walking and running.