Sarcopenia Predicts the Development of Early Adjacent Segment Disease After Transforaminal Lumbar Interbody Fusion

医学 肌萎缩 腰椎 腰大肌 优势比 单变量分析 外科 前凸 体质指数 骨盆倾斜 脊柱融合术 多元分析 骨盆 射线照相术 内科学
作者
Brandon Michael Wilkinson,Brendan Maloney,Jian Li,Hanish Polavarapu,Dan Draytsel,Ali Hazama
出处
期刊:Neurosurgery [Lippincott Williams & Wilkins]
被引量:1
标识
DOI:10.1227/neu.0000000000003201
摘要

BACKGROUND AND OBJECTIVES: Predicting the development of adjacent segment disease (ASD) after lumbar spine fusion would help guide preoperative and postoperative therapies to prevent reoperation. We sought to evaluate whether sarcopenia predicts the development of early ASD after transforaminal lumbar interbody fusion (TLIF). METHODS: Retrospective data were collected from 109 patients who underwent TLIF from 2013 to 2023. Patients older than 18 years who underwent elective posterior midline approach TLIF were included. Patients with prior lumbar instrumented fusions, cases of trauma, central nervous system infection, cancer, or long-construct thoracolumbar deformity corrections and those who lacked sufficient follow-up were excluded. The primary outcome was radiographic ASD development within 3 years of surgery. Psoas volumetric measurements were recorded from the most recent preoperative MRI. Odds ratios were calculated with logistic regression analyses. RESULTS: In 109 patients undergoing elective TLIF, 22 (20.2%) developed ASD within 3 years. Gender, body mass index, and extent of surgery were not associated with ASD development. Multivariate analysis showed left/right psoas cross-sectional area, and psoas:vertebral body ratio (P:VBR) predicted early ASD ( P < .0001). Sarcopenia was further categorized as having bilateral P:VBR ≥1 SD below gender mean ( T -score −1). Of 18 sarcopenic patients, 15 developed early ASD (83.33%) vs 7 of 91 nonsarcopenic patients (7.69%; P < .0001). Postoperative mismatch between pelvic incidence and lumbar lordosis was predictive of ASD on univariate ( P = .0480) but not multivariate analysis. Pelvic tilt and lumbar lordosis postoperatively were not associated with early ASD. CONCLUSION: Sarcopenia, measured by decreased psoas area and P:VBR, predicts ASD formation within 3 years of surgery. Morphometric analysis of psoas size is a simple tool to identify patients at risk of developing ASD. This information can potentially guide preoperative and postoperative therapies, affect surgical decision making, and effectively counsel patients on risks of reoperation.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
余生完成签到,获得积分10
刚刚
1秒前
1秒前
unique完成签到,获得积分10
1秒前
XYZ完成签到 ,获得积分10
1秒前
丘比特应助梅川秋裤采纳,获得10
2秒前
Jasper应助美好的觅珍采纳,获得10
2秒前
2秒前
我不李解发布了新的文献求助10
2秒前
明亮灭绝完成签到,获得积分10
2秒前
Hello应助alone采纳,获得10
2秒前
夏天完成签到,获得积分10
3秒前
3秒前
3秒前
silver_lin完成签到,获得积分10
4秒前
DD应助小小学神采纳,获得10
4秒前
火星上的山柳完成签到,获得积分10
5秒前
Chara0521完成签到,获得积分10
5秒前
开心的涵柳完成签到,获得积分10
6秒前
明亮灭绝发布了新的文献求助10
6秒前
6666完成签到,获得积分20
6秒前
milk发布了新的文献求助10
6秒前
平常日记本完成签到 ,获得积分10
7秒前
沉静从阳完成签到,获得积分10
7秒前
kk完成签到,获得积分20
7秒前
poppy发布了新的文献求助10
7秒前
jnum1完成签到,获得积分10
8秒前
两棵大白菜完成签到,获得积分10
9秒前
如梦完成签到,获得积分10
9秒前
123发布了新的文献求助10
9秒前
舒心如凡完成签到,获得积分10
9秒前
SCIAI应助bpg28采纳,获得10
10秒前
林一楠应助裴仰纳采纳,获得20
10秒前
鲁路修完成签到,获得积分10
10秒前
喜羊羊完成签到,获得积分10
10秒前
龙傲天完成签到,获得积分10
11秒前
orixero应助柠檬味的水采纳,获得10
11秒前
李健的粉丝团团长应助rock采纳,获得10
12秒前
12秒前
yar给刘钱美子的求助进行了留言
12秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3970287
求助须知:如何正确求助?哪些是违规求助? 3515034
关于积分的说明 11176923
捐赠科研通 3250301
什么是DOI,文献DOI怎么找? 1795244
邀请新用户注册赠送积分活动 875732
科研通“疑难数据库(出版商)”最低求助积分说明 805039