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Multifidus Sarcopenia Is Associated With Worse Patient-reported Outcomes Following Posterior Cervical Decompression
Zachariah W Pinter1, Harold I Salmons1, Sarah Townsley1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Spine
|July 7, 2022
Summary
Severe paraspinal sarcopenia negatively impacts recovery after posterior cervical decompression and fusion (PCDF). Patients with severe sarcopenia show less improvement in neck disability and physical function, with higher rates of worsening outcomes.
Area of Science:
- Spine surgery outcomes
- Musculoskeletal imaging
- Patient-reported outcome measures
Background:
- Sarcopenia's impact on lumbar surgery outcomes is known.
- The effect of sarcopenia on outcomes after posterior cervical decompression and fusion (PCDF) remains uninvestigated.
Purpose of the Study:
- To assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following PCDF.
- To determine if sarcopenia severity influences postoperative recovery and patient satisfaction.
Main Methods:
- Retrospective cohort study of 99 patients undergoing PCDF (C2-T2).
- T2-weighted MRI at C5-C6 assessed multifidus muscle fatty infiltration (Fuchs Modification of Goutalier grading).
- PROMs compared between mild, moderate, and severe sarcopenia subgroups.
Main Results:
- No significant preoperative PROM differences between subgroups.
- Postoperative Neck Disability Index scores were significantly higher in the severe sarcopenia group (21.0) compared to mild (12.8) and moderate (13.4) groups.
- Severe sarcopenia was associated with a higher likelihood of worsening postoperative Neck Disability Index, Visual Analog Scale Neck, and PROMIS Physical and Mental Component Scores.
Conclusions:
- Increased paraspinal sarcopenia severity correlates with poorer postoperative outcomes.
- Patients with severe sarcopenia experience less improvement in neck disability and physical function.
- Severe sarcopenia is a significant predictor of worsening patient-reported outcomes after PCDF.
