Asymmetrical atrophy of the paraspinal muscles in patients undergoing unilateral lumbar medial branch radiofrequency neurotomy

被引:1
|
作者
Guven, Ali E. [1 ]
Evangelisti, Gisberto [1 ,2 ]
Burkhard, Marco D. [1 ]
Koehli, Paul [1 ,3 ]
Hambrecht, Jan [1 ]
Zhu, Jiaqi [4 ]
Chiapparelli, Erika [1 ]
Kelly, Michael [1 ]
Tsuchiya, Koki [1 ,5 ]
Amoroso, Krizia [1 ]
Zadeh, Arman [1 ]
Shue, Jennifer [1 ]
Tan, Ek Tsoon [6 ]
Sama, Andrew A. [1 ]
Girardi, Federico P. [1 ]
Cammisa, Frank P. [1 ]
Hughes, Alexander P. [1 ]
机构
[1] Hosp Special Surg, Dept Orthopaed Surg, 535 East,70th St, New York, NY 10021 USA
[2] IRCCS Ist Ortoped Rizzoli, Dept Spine Surg, Bologna, Italy
[3] Charite Univ Med Berlin, Ctr Musculoskeletal Surg, Berlin, Germany
[4] Hosp Special Surg, Biostat Core, New York, NY 10021 USA
[5] Showa Univ Hosp, Sch Med, Dept Orthopaed Surg, Tokyo, Japan
[6] Hosp Special Surg, Dept Radiol & Imaging, New York, NY 10021 USA
关键词
Back pain; Radiofrequency neurotomy; Medial branch; Multifidus; Facet joint; ZYGAPOPHYSIAL JOINT; MULTIFIDUS; OSTEOARTHRITIS; SPINE;
D O I
10.1097/j.pain.0000000000003223
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Greater atrophy of the multifidus muscle occurs on the ablated side, compared with the contralateral, in patients undergoing unilateral lumbar medial branch radiofrequency neurotomy. Lumbar medial branch radiofrequency neurotomy (RFN), a common treatment for chronic low back pain due to facet joint osteoarthritis (FJOA), may amplify paraspinal muscle atrophy due to denervation. This study aimed to investigate the asymmetry of paraspinal muscle morphology change in patients undergoing unilateral lumbar medial branch RFN. Data from patients who underwent RFN between March 2016 and October 2021 were retrospectively analyzed. Lumbar foramina stenosis (LFS), FJOA, and fatty infiltration (FI) functional cross-sectional area (fCSA) of the paraspinal muscles were assessed on preinterventional and minimum 2-year postinterventional MRI. Wilcoxon signed-rank tests compared measurements between sides. A total of 51 levels of 24 patients were included in the analysis, with 102 sides compared. Baseline MRI measurements did not differ significantly between the RFN side and the contralateral side. The RFN side had a higher increase in multifidus FI (+4.2% [0.3-7.8] vs +2.0% [-2.2 to 6.2], P = 0.005) and a higher decrease in multifidus fCSA (-60.9 mm2 [-116.0 to 10.8] vs -19.6 mm2 [-80.3 to 44.8], P = 0.003) compared with the contralateral side. The change in erector spinae FI and fCSA did not differ between sides. The RFN side had a higher increase in multifidus muscle atrophy compared with the contralateral side. The absence of significant preinterventional degenerative asymmetry and the specificity of the effect to the multifidus muscle suggest a link to RFN. These findings highlight the importance of considering the long-term effects of lumbar medial branch RFN on paraspinal muscle health.
引用
收藏
页码:2130 / 2134
页数:5
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