Cervical extensor muscles involution in patients with symptomatic degenerative conditions: Comparative analysis and...

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Fatty infiltration (FI) in paraspinal muscles is linked to pain and instability.
• Cervical spine conditions like myelopathy and spondylosis show increased FI in neck muscles, correlating with pain and disability.
• This study investigates cervical extensor muscle composition in preoperative imaging.

Purpose of the Study:

• To analyze the composition of cervical extensor muscles in preoperative imaging.
• To correlate muscle fatty infiltration (FI) with cervical alignment and demographic parameters in patients undergoing cervical spine surgery.
• To compare FI levels between anterior and posterior surgical approaches for cervical spondylosis.

Main Methods:

• Retrospective study of adult patients undergoing cervical myelopathy surgery (ACDF or laminectomy).
• Evaluation of preoperative T2-weighted MRI for fat infiltration (FI) and X-rays for cervical alignment.
• Assessment of FI to muscle tissue ratio in C2-C7 paraspinal extensor muscles; logistic regression analysis.

Main Results:

• Higher %FI was observed in posterior (PT) surgical group patients compared to anterior (AT) group (5.0% ± 7.6% vs. 1.8% ± 2.6%, p=0.015).
• Multivariate analysis revealed lower odds of spondylosis with lower T1S values (OR 0.94) and lower FI (OR 0.83).
• Patients with single or multilevel stenosis exhibited significantly higher %FI in extensor muscles.

Conclusions:

• Patients undergoing posterior surgery for cervical spondylosis show greater extensor muscle fatty infiltration.
• Lower cervical lordosis (CL) and T1 slope (T1S) values are associated with anterior compression.
• Fatty infiltration and specific cervical alignment parameters correlate with spondylosis severity and surgical approach.