General Session: Diagnostic Imaging
Presented by: K. Siemionow
P. Glowka(1,2), K. Siemionow(2), P. Janusz(1)
(1) University of Medical Sciences, Department of Spinal Disorders and Pediatric Orthopaedics, Poznan, Poland
(2) University of Illinois at Chicago, Department of Orthopaedics, Chicago, IL, United States
Background: The purpose of the study was to evaluated cervical extensor muscles atrophy after indirect root decompression with fusion with posterior cervical cages placed bilaterally in the facet joints.
Methods: The study include 30 patients undergone bilateral the indirect root decompression with posterior cervical cages placed bilaterally in the facet joints. Patients were examined twice with CT: presurgery and at the one year follow-up point. The following cervical muscles cross sectional area (CSA) was measured on both pre- and post-surgery CR-scans: multifidus, semispinalis cervicis, semispinalis capitis, splenicus. The presurgery and posturgery lordosis was measured on the standing X-rays of cervical spine. The clinical outcomes were evaluated with Neck Disability Index (NDI), Visual Analoque Scale (VAS) for neck pain and VAS for arm pain.
Results: The differences between the pre-surgery and post-surgery muscles CSA (ΔCSA )were significant for following cervical muscles: multifidus, semispinalis cervicis, semispinalis capitis. There was no significant difference for presurgery and one-year follow-up muscle CSA of: splenicus muscle (both right and left sided), right semispinalis cervicis and semispinalis capitis. There was no significant correlation between the ΔCSA and NDI improvement, VAS for arm and VAS for neck scale, but the positive correlation of VAS for neck improvement and left splenicus ΔCSA (r=0.517195, p< 0.05). Age of the patients presents the negative correlation with ΔCSA, but only the result for left multifidus was statistically significant (p=-0.41452).
Conclusions: Comparing the muscle atrophy related to different procedures we observe the decrease of atrophy related to the invasiveness of exposure. Our results presents less atrophy than in aforementioned open approach procedures emphasizing the importance of lessen the muscle injury in terms of cervical extensor muscles atrophy.