Does paraspinal muscle morphometry predict functional status and re-operation after lumbar spinal surgery? A...

Area of Science:

• Spinal Surgery
• Musculoskeletal Imaging
• Clinical Outcomes Research

Background:

• The relationship between paraspinal muscle degeneration and clinical outcomes after lumbar surgery remains unclear.
• This uncertainty limits the clinical application of paraspinal muscle morphology assessment.
• Accurate prediction of postoperative outcomes is crucial for patient management.

Approach:

• A comprehensive literature review identified 6917 articles, with 10 studies meeting inclusion criteria.
• Meta-analysis and vote counting models assessed preoperative paraspinal muscle morphology (multifidus, erector spinae, psoas major) against outcomes like ODI, pain, and revision surgery.

Key Points:

• Higher preoperative multifidus fat infiltration predicts worse postoperative Oswestry Disability Index scores.
• Multifidus fat infiltration is also a predictor of persistent low back pain after surgery.
• Evidence for erector spinae and psoas major predictive value is limited.

Conclusions:

• Assessment of multifidus (MF) fat infiltration (FI) is a viable method for stratifying patients undergoing lumbar surgery.
• MF FI can predict the risk of severe functional disability and low back pain post-surgery.
• Preoperative evaluation of paraspinal muscle morphology, particularly MF FI, is beneficial for surgical planning.