Age-Related Association Between Unilateral Single-Channel and Double-Channel Surgery and Postoperative Multifidus...

Area of Science:

• Spine surgery
• Orthopedics
• Minimally invasive spinal surgery (MISS)

Background:

• Limited research exists on lumbosacral multifidus muscle injuries in elderly patients undergoing MISS for lumbar spinal canal stenosis.
• Unilateral biportal endoscopic laminotomy (UBE) and percutaneous endoscopic laminotomy (PEL) are common MISS techniques.

Purpose of the Study:

• To investigate the impact of single-channel and double-channel MISS on multifidus muscle atrophy and fat infiltration in elderly patients.
• To compare these effects between younger (<65 years) and older (≥65 years) patient groups.

Main Methods:

• 107 patients undergoing MISS were divided into two cohorts: <65 years (Group A) and ≥65 years (Group B).
• Preoperative MRI data were used to assess stenosis and classify nerve root compression.
• Multifidus muscle atrophy and fat infiltration were quantified by measuring the fat-free cross-sectional area (FCSA)/cross-sectional area (CSA) ratio before and after surgery.

Main Results:

• No significant changes in multifidus muscle atrophy or fat infiltration were observed between procedures in Group A (P>.05).
• Significant increases in multifidus muscle atrophy and fat infiltration were found in Group B (P<.05).

Conclusions:

• Single-channel and double-channel MISS do not significantly affect multifidus muscles in patients under 65.
• In patients aged 65 and older, MISS leads to increased multifidus muscle atrophy and fat infiltration, correlated with lateral recess stenosis and longer surgical times.