Association between severity of the cervical foraminal stenosis and paraspinal muscle parameters in patients undergoing anterior cervical discectomy and fusion

被引：1

作者：

Caffard, Thomas ^{[1
,2
]}

Arzani, Artine ^{[1
]}

Verna, Bruno ^{[1
]}

Tripathi, Vidushi ^{[1
]}

Medina, Samuel J. ^{[1
]}

Schoennagel, Lukas ^{[1
,3
,4
,5
]}

Chiapparelli, Erika ^{[1
]}

Tani, Soji ^{[1
,6
]}

Camino-Willhuber, Gaston ^{[1
]}

Guven, Ali E. ^{[1
,3
,4
,5
]}

Amoroso, Krizia ^{[1
]}

Zhu, Jiaqi ^{[7
]}

Tan, Ek Tsoon ^{[8
]}

Carrino, John A. ^{[8
]}

Malik, Hassan Awan ^{[2
]}

Zippelius, Timo ^{[2
]}

Shue, Jennifer ^{[1
]}

Mb, David M. Dalton ^{[1
]}

Sama, Andrew A. ^{[1
]}

Girardi, Federico P. ^{[1
]}

Cammisa, Frank P. ^{[1
]}

Hughes, Alexander P. ^{[1
,9
]}

机构：

[1] Hosp Special Surg, Spine Care Inst, New York, NY USA

[2] Univ Ulm, Dept Orthoped Surg, Ulm, Germany

[3] Charite Univ Med Berlin, Ctr Musculoskeletal Surg, Berlin, Germany

[4] Free Univ Berlin, Berlin, Germany

[5] Humboldt Univ, Berlin, Germany

[6] Showa Univ Hosp, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[7] Hosp Special Surg, Biostat Core, New York, NY USA

[8] Hosp Special Surg, Dept Radiol & Imaging, New York, NY USA

[9] Hosp Special Surg, Spine Care Inst, New York, NY 10021 USA

来源：

JOURNAL OF NEUROSURGERY-SPINE | 2024年 / 40卷 / 03期

关键词：

cervical foraminal stenosis; muscle fat infiltration; multifidus; rotatores; MULTIFIDUS MUSCLE; DISC; INFILTRATION; ASYMMETRY;

D O I：

10.3171/2023.10.SPINE23658

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE The cervical multifidus and rotatores muscles are innervated by the posterior rami of the spinal nerves of the corresponding level, and it has been hypothesized that cervical foraminal stenosis (CFS) affecting the spinal nerves results in changes in these muscles. The purpose of this study was to evaluate the relationship between the severity of CFS and fat infiltration (FI) of the multifidus and rotatores muscles. METHODS Patients who received preoperative cervical MRI, underwent anterior cervical decompression and fusion between 2015 and 2018, and met inclusion and exclusion criteria were included. Multifidus and rotatores muscles were segmented bilaterally from C3 to C7, and the percent FI was measured using custom-written MATLAB software. The severity of the CFS was assessed by the Kim classification. Multivariable linear mixed models were conducted and adjusted for age, sex, BMI, and repeated measures. RESULTS In total, 149 patients were included. Linear mixed modeling results showed that a more severe CFS at C3-4 was correlated with a greater FI of the multifidus and rotatores muscles at C4 (estimate 0.034, 95% CI 0.003-0.064; p = 0.031), a more severe CFS at C4-5 was correlated with a greater FI of the multifidus and rotatores muscles at C5 (estimate 0.037, 95% CI 0.015-0.057; p < 0.001), a more severe CFS at C5-6 was correlated with a greater FI of the multifidus and rotatores muscles at C6 (estimate 0.041, 95% CI 0.019-0.062; p < 0.001) and C7 (estimate 0.035, 95% CI 0.012-0.058; p = 0.003), and a more severe CFS at C6-7 was correlated with a greater FI of the multifidus and rotatores muscles at C7 (estimate 0.049, 95% CI 0.027-0.071; p < 0.001). CONCLUSIONS These results demonstrated level- and side-specific correlations between the FI of the multifidus and rotatores muscles and severity of CFS. Given the segmental innervation of the multifidus and rotatores muscles, the authors hypothesize that the observed increased FI could be reflective of changes due to muscle denervation from CFS.

引用

页码：274 / 281

页数：8