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논문 기본 정보

자료유형
학술저널
저자정보
Wang Guodong (Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China) Li Yang (Shandong Provincial Hospital, Shandong University, Jinan, China) Zhang Chenggui (Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China) Liu Ping (Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China) Sun Jianmin (Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.18 No.1
발행연도
2024.2
수록면
50 - 57 (8page)
DOI
10.31616/asj.2023.0138

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Study Design: Retrospective cohort study. Purpose: This study aimed to investigate the relationship between lumbar erector muscle atrophy and global sagittal imbalance in lumbar degenerative kyphosis (LDK) and with postoperative proximal junctional kyphosis. Overview of Literature: Lumbar erector muscle atrophy has been studied in LDK. However, its role in the compensatory mechanism is still under intense discussion, and the role of erector spinae (ES) muscle is always overlooked. Methods: This study enrolled 51 patients with LDK out of 382 patients with adult degenerative spinal deformity. Baseline information was reviewed including demographic data and complications. Sagittal spinopelvic alignments and global imbalance parameters were assessed on full-length X-ray images of the spine. Muscularity and the fatty infiltration area of the ES and multifidus (MF) were measured at the L4/5 level on preoperative magnetic resonance image to evaluate the lumbar erector muscle atrophy. Stratification by sagittal vertical axis (SVA) was performed: group 1 with SVA <100 mm and group 2 with SVA >100 mm, and these groups were compared. Spearman correlation and multivariable logistic regression analyses were performed to analyze and define risk factors of postoperative proximal junctional kyphosis (PJK). Results: Group 2 had lower ES and MF muscularity than group 1. ES muscularity correlated with SVA (r=−0.510, p=0.003), lumbar lordosis (r=−0.415, p=0.018), and postoperative PJK (r=−0.508, p=0.022). MF muscularity did not correlate with the above parameters. Multivariable logistic regression analysis verified ES muscularity (odds ratio [OR], 0.001; p=0.039) and SVA (OR, 1.034; p=0.048) as the risk factors for postoperative PJK. Conclusions: ES atrophy, besides the MF, is an important predictor in distinguishing decompensated LDK from well-compensated ones. It plays an important role in compensatory mechanism, not only correlates with global sagittal imbalance but also ties to PJK after deformity corrective surgery.

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