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Postoperative changes in paraspinal muscle thickness after various lumbar back surgery procedures
H Suwa1, J Hanakita, N Ohshita
1Department of Neurosurgery, Shizuoka General Hospital.
Neurologia Medico-Chirurgica
|June 8, 2000
Summary
Posterior fusion surgery causes the most paraspinal muscle damage in lumbar procedures. This muscle damage may lead to significant muscle atrophy after surgery.
Area of Science:
- Orthopedics
- Neurosurgery
- Muscle Physiology
Background:
- Lumbar back surgery can lead to paraspinal muscle damage.
- Assessing this damage is crucial for understanding postoperative outcomes.
Purpose of the Study:
- To evaluate paraspinal muscle damage after different lumbar back surgery procedures.
- To compare the invasiveness of single interlaminar, multiple interlaminar, and posterolateral fusion procedures on paraspinal muscles.
Main Methods:
- Measured paraspinal muscle thickness preoperatively and postoperatively in 89 patients.
- Categorized procedures into single interlaminar (SL), multiple interlaminar (ML), and posterolateral fusion (PLF) groups.
- Assessed muscle thickness changes >10 months post-surgery and measured serum creatine phosphokinase (CPK) levels on postoperative day 2.
Main Results:
- Posterolateral fusion (PLF) showed a significantly larger decrease in paraspinal muscle thickness (-12.9%) compared to single interlaminar (SL) procedures (-2.7%).
- Postoperative CPK levels were significantly higher in the PLF group than in SL and ML groups.
- No significant correlation was found between postoperative CPK levels and the decrease in paraspinal muscle thickness.
Conclusions:
- Posterolateral fusion (PLF) is the most invasive procedure concerning paraspinal muscles among the evaluated lumbar surgeries.
- Paraspinal muscle damage during lumbar surgery is a key factor contributing to muscle atrophy.