| The Relationship of Trunk Muscles of Lumbar Spine and Union Rates After Posterior Lumbar Interbody Fusion In Elderly |
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Bang Ryu , Sung Bum Kim , Bong Jin Park , Tae Sung Kim , Young Jin Lim |
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Department of Neurosurgery, Kyung Hee University School of Medicine, Seoul, Korea |
| 노인 환자에서 후방 요추 추체간 유합술 후 유합률과 체간 근육 간의 관계에 대한 고찰 |
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류 방·김승범·박봉진·김태성·임영진 |
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경희대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
Trunk muscles in the lumbar spine function as preserving the spinal stability, motility. However, when compared with the other factors affecting bone union after spinal surgery, there are no literatures evaluating the relationship about trunk muscles and bone fusion rate. The aim of this study is to evaluate the correlation of the trunk muscles cross sectional area and stand-alone cage posterior lumbar interbody fusion (PLIF) rates.
Methods
A total of 32 adult patients over 60 years old with degenerative lumbar disease, who were performed with stand-alone cage PLIF at L4-L5 without pedicle screw fixation were included in this study. The quantitative evaluation of Psoas major (PS), Erector spinae (ES), Multifidus muscle (MF) strength (cross-sectional area) were measured by preoperative lumbar magnetic resonance image at L3-L4, L4-L5, L5-S1 segments and the bone union was evaluated by dynamic lumbar X-rays.
Results
Of the 32 patients, 24 had union and 8 had not. The difference of PS muscle cross-sectional area (MCSA) at L4-L5, L5-S1 segments in both groups was statistically valued (p<0.05), however, the ES and MF were not. The multivariate analysis revealed that statistically significance was found only in the PS MCSA at L5-S1 segments (p=0.021, OR=1.379).
Conclusion
In union group, the PS MCSA was larger than non-union group. But, ES and MF were not. In PLIF surgery, we suggest that the PS muscle functions are important factor for bone union, and for better fusion rate, preventing back muscle injury is essential. |
| Key Words:
Trunk muscleㆍPosterior lumbar interbody fusion ratesㆍCross-sectional area |
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