Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles?
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://hdl.handle.net/10216/134370 |
Resumo: | Study design: Retrospective analisys of prospective collected data study. Objective: To study the prognostic value of paravertebral lumbar muscles atrophy on clinical outcome after lumbar surgery on patients with symptomatic lumbar disc herniation. Summary of Background Data: Cross sectional area (CSA) and fat infiltration (FI) are the best parameters to assess paravertebral muscle atrophy. The role of muscle atrophy in the outcome of patients with symptomatic lumbar disc herniation undergoing surgery remains unclear. Methods: Patients over 18 years old with lumbar disc herniation and radicular pain who underwent single-level discectomy were included. Multifidus, erector spinae and psoas CSA and FI were measured by ImageJ software at the levels of L3-L4, L4-L5 and L5-S1 from T2-weighted MRI axial images. Clinical status was assessed preoperative and one-year postoperative with patient reported outcome measurements (PROMS), that included NRS for back and leg pain, COMI, ODI and EuroQoL-5D. Univariate and multiple linear regression were performed. Results: There where were negative correlations between psoas muscle CSA on the symptomatic side and preoperative PROMS. Erector spinae FI was the only muscle-related factor that correlated to post-surgery PROMS. The relation between erector spinae FI and postoperative COMI was split in three groups: FI < 15%, FI 15-30%, FI > 30%. Postoperative COMI was higher in FI>30% group (median: 4.4, IQR: 3.2) and lower in FI < 15% (median: 1.2, IQR: 1.6) (Kruskal-Wallis, p<0.001). Male gender was associated with better outcome as well as erector spinae FI < 15%, while FI > 30% was related to worse postoperative status. Conclusions: Increased fat infiltration of erector spinae muscles correlates to less favourable clinical outcomes following lumbar discectomies. |
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Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles?Medicina clínicaClinical medicineStudy design: Retrospective analisys of prospective collected data study. Objective: To study the prognostic value of paravertebral lumbar muscles atrophy on clinical outcome after lumbar surgery on patients with symptomatic lumbar disc herniation. Summary of Background Data: Cross sectional area (CSA) and fat infiltration (FI) are the best parameters to assess paravertebral muscle atrophy. The role of muscle atrophy in the outcome of patients with symptomatic lumbar disc herniation undergoing surgery remains unclear. Methods: Patients over 18 years old with lumbar disc herniation and radicular pain who underwent single-level discectomy were included. Multifidus, erector spinae and psoas CSA and FI were measured by ImageJ software at the levels of L3-L4, L4-L5 and L5-S1 from T2-weighted MRI axial images. Clinical status was assessed preoperative and one-year postoperative with patient reported outcome measurements (PROMS), that included NRS for back and leg pain, COMI, ODI and EuroQoL-5D. Univariate and multiple linear regression were performed. Results: There where were negative correlations between psoas muscle CSA on the symptomatic side and preoperative PROMS. Erector spinae FI was the only muscle-related factor that correlated to post-surgery PROMS. The relation between erector spinae FI and postoperative COMI was split in three groups: FI < 15%, FI 15-30%, FI > 30%. Postoperative COMI was higher in FI>30% group (median: 4.4, IQR: 3.2) and lower in FI < 15% (median: 1.2, IQR: 1.6) (Kruskal-Wallis, p<0.001). Male gender was associated with better outcome as well as erector spinae FI < 15%, while FI > 30% was related to worse postoperative status. Conclusions: Increased fat infiltration of erector spinae muscles correlates to less favourable clinical outcomes following lumbar discectomies.2021-05-262021-05-26T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttps://hdl.handle.net/10216/134370TID:202849376engJuliana Cardoso Costa Santosinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T14:07:27Zoai:repositorio-aberto.up.pt:10216/134370Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T23:55:24.327849Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
title |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
spellingShingle |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? Juliana Cardoso Costa Santos Medicina clínica Clinical medicine |
title_short |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
title_full |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
title_fullStr |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
title_full_unstemmed |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
title_sort |
Is the outcome after lumbar discectomy impacted by fatty infiltration of paraspinal muscles? |
author |
Juliana Cardoso Costa Santos |
author_facet |
Juliana Cardoso Costa Santos |
author_role |
author |
dc.contributor.author.fl_str_mv |
Juliana Cardoso Costa Santos |
dc.subject.por.fl_str_mv |
Medicina clínica Clinical medicine |
topic |
Medicina clínica Clinical medicine |
description |
Study design: Retrospective analisys of prospective collected data study. Objective: To study the prognostic value of paravertebral lumbar muscles atrophy on clinical outcome after lumbar surgery on patients with symptomatic lumbar disc herniation. Summary of Background Data: Cross sectional area (CSA) and fat infiltration (FI) are the best parameters to assess paravertebral muscle atrophy. The role of muscle atrophy in the outcome of patients with symptomatic lumbar disc herniation undergoing surgery remains unclear. Methods: Patients over 18 years old with lumbar disc herniation and radicular pain who underwent single-level discectomy were included. Multifidus, erector spinae and psoas CSA and FI were measured by ImageJ software at the levels of L3-L4, L4-L5 and L5-S1 from T2-weighted MRI axial images. Clinical status was assessed preoperative and one-year postoperative with patient reported outcome measurements (PROMS), that included NRS for back and leg pain, COMI, ODI and EuroQoL-5D. Univariate and multiple linear regression were performed. Results: There where were negative correlations between psoas muscle CSA on the symptomatic side and preoperative PROMS. Erector spinae FI was the only muscle-related factor that correlated to post-surgery PROMS. The relation between erector spinae FI and postoperative COMI was split in three groups: FI < 15%, FI 15-30%, FI > 30%. Postoperative COMI was higher in FI>30% group (median: 4.4, IQR: 3.2) and lower in FI < 15% (median: 1.2, IQR: 1.6) (Kruskal-Wallis, p<0.001). Male gender was associated with better outcome as well as erector spinae FI < 15%, while FI > 30% was related to worse postoperative status. Conclusions: Increased fat infiltration of erector spinae muscles correlates to less favourable clinical outcomes following lumbar discectomies. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05-26 2021-05-26T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://hdl.handle.net/10216/134370 TID:202849376 |
url |
https://hdl.handle.net/10216/134370 |
identifier_str_mv |
TID:202849376 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799135874595684352 |