Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion

Zhang, Xin1; Wang, Song1; Zheng, Junyong1; Xiao, Xiao2,3; Wang, Hongyu2,3; Peng, Songlin1,2,3,4,5

2024-06-01

10.31616/asj.2023.0447

ASIAN SPINE JOURNAL   影响因子和分区

1976-1902

1976-7846

Study Design: A retrospective cohort study. Purpose: This study aimed to assess the reliability of quantitative computed tomography (QCT) in measuring bone mineral density (BMD) of instrumented vertebrae and investigate the effect of less paraspinal muscle damage on BMD changes after lumbar interbody fusion. Overview of Literature: Patients always experience a decrease in vertebral BMD after lumbar interbody fusion. However, to the best of our knowledge, no study has analyzed the effect of paraspinal muscles on BMD changes. Methods: This retrospective analysis included a total of 155 patients who underwent single-level lumbar fusion, with 81 patients in the traditional group and 74 patients in the Wiltse group (less paraspinal muscle damage). QCT was used to measure the volumetric BMD (vBMD), Hounsfield unit value, and cross-sectional area of the paraspinal muscles at the upper instrumented vertebrae (UIV), vertebrae one segment above the UIV (UIV+1), and the vertebrae one segment above the UIV+1 (UIV+2). Statistical analyses were performed. Results: No significant differences in general data were observed between the two groups ( p >0.05). Strong correlations were noted between the preoperative and 1-week postoperative vBMD of each segment ( p <0.01), with no significant difference between the two time points in both groups ( p >0.05). Vertebral BMD loss was significantly higher in UIV+1 and UIV+2 in the traditional group than in the Wiltse group (-13.6%+/- 19.1% vs. -4.2%+/- 16.5%, -10.8%+/- 20.3% vs. -0.9%+/- 37.0%; p <0.05). However, no statistically significant difference was observed in the percent vBMD changes in the UIV segment between the two groups (37.7%+/- 70.1% vs. 36.1%+/- 78.7%, p >0.05). Conclusions: QCT can reliably determine BMD in the instrumented spine after lumbar interbody fusion. With QCT, we found that reducing paraspinal muscle destruction through the Wiltse approach during surgery can help preserve the adjacent vertebral BMD; however, it does not help increase the BMD in the instrumented vertebrae.

Lumbar vertebrae Bone mineral density Lumbar interbody fusion Paraspinal muscles Quantitative computed tomography

ESCI

英语

通讯

Na-tional Nature Science Foundation of China[82272488]

Orthopedics

Orthopedics

WOS:001253714800001

KOREAN SOC SPINE SURGERY

Web of Science

1.Jinan Univ, Clin Med Coll 2, Shenzhen, Peoples R China
2.Jinan Univ, Clin Med Coll 2, Shenzhen Peoples Hosp, Dept Orthopaed Surg,Div Spine Surg, Shenzhen 518020, Peoples R China
3.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen, Peoples R China
4.Shenzhen Key Lab Musculoskeletal Tissue Reconstruc, Shenzhen, Peoples R China
5.Shenzhen Peoples Hosp, Shenzhen Clin Res Ctr Geriatr, Shenzhen, Peoples R China

Zhang, Xin,Wang, Song,Zheng, Junyong,et al. Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion[J]. ASIAN SPINE JOURNAL,2024.

Zhang, Xin,Wang, Song,Zheng, Junyong,Xiao, Xiao,Wang, Hongyu,&Peng, Songlin.(2024).Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion.ASIAN SPINE JOURNAL.

Zhang, Xin,et al."Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion".ASIAN SPINE JOURNAL (2024).