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Lim HJ, Yoon H, Kim J, Han K, So Y, Park M, Park KB, Lee MJ. Comparison of elasticity changes in the paraspinal muscles of adolescent patients with scoliosis treated with surgery and bracing. Sci Rep 2024; 14:5623. [PMID: 38453994 PMCID: PMC10920829 DOI: 10.1038/s41598-024-56189-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
Scoliosis is a three-dimensional spinal deformity, and paraspinal muscles play an important role as stabilizers of the spinal curve. In this prospective study, we compared elasticity changes in the paraspinal muscles of adolescent patients with scoliosis after surgery or bracing. Elasticity was measured on the concave and convex sides of the paraspinal muscles at the apex of the curve at the beginning of treatment and 6 and 12 months after treatment. Twenty-six patients with correction surgery (n = 15) or bracing (n = 11) were included. At initial evaluation, the Cobb angle was larger in the surgery group (72.3 ± 20.2° in surgery vs. 30.6 ± 5.1° in brace, p < 0.001). The estimated mean elasticity value of the paraspinal muscles was lower in the surgery group at baseline on the convex side (15.8 vs. 22.8 kPa, p = 0.037) and 6 months on both the concave (12.1 vs. 22.7 kPa, p = 0.004) and convex (13.4 vs. 23.8 kPa, p = 0.005) sides. There was a significant stiffness decrease from baseline to 6 months on the concave side in the surgery group (5.9 kPa, p = 0.025). However, the elasticity change recovered at 12 months without significant differences between the two groups.
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Affiliation(s)
- Hyun Ji Lim
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Haesung Yoon
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Jisoo Kim
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Kyunghwa Han
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yuri So
- Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, South Korea
| | - Mincheol Park
- Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kun-Bo Park
- Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| | - Mi-Jung Lee
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
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Suo M, Zhang J, Sun T, Wang J, Liu X, Huang H, Li Z. The association between morphological characteristics of paraspinal muscle and spinal disorders. Ann Med 2023; 55:2258922. [PMID: 37722876 PMCID: PMC10512810 DOI: 10.1080/07853890.2023.2258922] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Spinal disorders affect millions of people worldwide, and can cause significant disability and pain. The paraspinal muscles, located on either side of the spinal column, play a crucial role in the movement, support, and stabilization of the spine. Many spinal disorders can affect paraspinal muscles, as evidenced by changes in their morphology, including hypertrophy, atrophy, and degeneration. OBJECTIVES The objectives of this review were to examine the current literature on the relationship between the paraspinal muscles and spinal disorders, summarize the methods used in previous studies, and identify areas for future research. METHODS We reviewed studies on the morphological characteristics of the paravertebral muscle and discussed their relationship with spinal disorders, as well as the current limitations and future research directions. RESULTS The paraspinal muscles play a critical role in spinal disorders and are important targets for the treatment and prevention of spinal disorders. Clinicians should consider the role of the paraspinal muscles in the development and progression of spinal disorders and incorporate assessments of the paraspinal muscle function in clinical practice. CONCLUSION The findings of this review highlight the need for further research to better understand the relationship between the paraspinal muscles and spinal disorders, and to develop effective interventions to improve spinal health and reduce the burden of spinal disorders.
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Affiliation(s)
- Moran Suo
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
| | - Jing Zhang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
| | - Tianze Sun
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
| | - Jinzuo Wang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
| | - Xin Liu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
| | - Huagui Huang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, P.R. China
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Incesoy MA, Seluk S, Turk OI, Buyuk AF, Erdogan S, Misir A. Is Lenke type V adolescent idiopathic scoliosis associated with different muscular morphometry? J Pediatr Orthop B 2023; 32:363-368. [PMID: 36125904 DOI: 10.1097/bpb.0000000000001002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of the study was to evaluate the changes in psoas major (PM), erector spinae (ES), multifidus (MF), and rectus abdominis (RA) morphometry in Lenke type V adolescent idiopathic scoliosis (AIS) and control. Forty-two Lenke V AIS patients and 30 control were enrolled. The cross-sectional area (CSA) and CSA index (CI) of the PM, ES, MF, and RA at the T9-L5 levels were measured and compared between Lenke type V patients and control. The CI of the RA was significantly higher in the control group than the Lenke V group in multiple levels. On the other hand, there was no significant difference between patients with Lenke V AIS and control regarding the CI of the RA, ES, and PM. There was no significant difference between concave and convex sides of the Lenke V group regarding the CI of the RA, PM, MF, and ES. RA muscle mass is significantly affected in Lenke type 5 AIS regardless of convex or concave sides. This difference may be related to postural differences and back pain development in Lenke type 5 patients. Level of evidence: Level III.
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Affiliation(s)
| | - Sefa Seluk
- Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital
| | | | - Abdul Fettah Buyuk
- Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital
| | - Sinan Erdogan
- Department of Orthopedics, Kanuni Sultan Suleyman Training and Research Hospital
| | - Abdulhamit Misir
- Department of Orthopedics, Istanbul Medicana Health Group, Istanbul, Turkey
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Kim HJ, Yang JH, Chang DG, Suk SI, Suh SW, Song KS, Kang KC, Kim YH. Significance of paraspinal muscle quality in risk between single and multiple osteoporotic vertebral fractures. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:1763-1770. [PMID: 36977941 DOI: 10.1007/s00586-023-07670-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/20/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE To compare paraspinal muscle quality between patients with single and multiple osteoporotic vertebral fractures (OVFs) and evaluate the role of the paraspinal muscles in OVFs. METHODS A total of 262 consecutive patients with OVFs were retrospectively analyzed in two groups: those with single OVF (n = 173) and those with multiple OVFs (n = 89). The cross-sectional area (CSA) and fatty degeneration of the paraspinal muscles were calculated from axial T2-weighted magnetic resonance imaging at the level of the L4 upper endplate by manual tracing in ImageJ software. Pearson's correlation analysis was performed to analyze correlations of paraspinal muscle quality to multiple OVFs. RESULTS FD in all the paraspinal muscles was significantly higher in the multiple OVF group than the single OVF group (all p < 0.005). The functional CSA (fCSA) of the paraspinal muscles was significantly lower in the multiple OVF group than the single OVF group (all Ps < 0.001), except for the erector spine (p = 0.304). The Pearson's correlation analysis showed significant positive inter-correlations for the fCSAs of all the paraspinal muscles and the occurrence of multiple OVFs. CONCLUSIONS The pure muscle volumes of the multifidus, psoas major, and quadratus lumborum were lower in patients with multiple OVFs than in those with a single OVF. Furthermore, the inter-correlation among all the paraspinal muscles indicate that the muscle-bone crosstalk profoundly existed in vertebral fracture cascade. Therefore, special attention to paraspinal muscle quality is needed to prevent progression to multiple OVFs.
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Affiliation(s)
- Hong Jin Kim
- Spine Center and Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, 1342, Dongil-Ro, Nowon-Gu, Seoul, 01757, Republic of Korea
| | - Jae Hyuk Yang
- Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Dong-Gune Chang
- Spine Center and Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, 1342, Dongil-Ro, Nowon-Gu, Seoul, 01757, Republic of Korea.
| | - Se-Il Suk
- Spine Center and Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, 1342, Dongil-Ro, Nowon-Gu, Seoul, 01757, Republic of Korea
| | - Seung Woo Suh
- Department of Orthopedic Surgery, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kwang-Sup Song
- Department of Orthopedic Surgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Kyung-Chung Kang
- Department of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Hoon Kim
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Pan A, Cao W, Wu B, Yin L, Ding H, Guo R, Liu Y, Hai Y, Zhou L. Elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis after posterior selective fusion surgery. Clin Biomech (Bristol, Avon) 2022; 99:105763. [PMID: 36122528 DOI: 10.1016/j.clinbiomech.2022.105763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND We sought to assess the elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis patients with Lenke Type 1, 2, or 3 curves after posterior selective fusion surgery. METHODS The shear wave elasticity imaging system was used to assess the elasticity of the thoracic paravertebral muscles and fascia both on the concave and convex sides. Three regions of interest, including the apex, upper end, and lower end of the main curve, were tested. FINDINGS Ten female patients, with an average age of 16.6 ± 2.7 years old, were included. The average post-operation follow-up period was 9.0 ± 2.4 months. The Cobb angle was significantly corrected from 63.6 ± 12.0° to 10.7 ± 5.4° (p < 0.05). The length of the trunk increased from 40.4 ± 2.5 cm to 46.0 ± 2.8 cm (p < 0.05). The elasticity of deep fascia didn't show a significant change post-operation (p > 0.05). The elasticity of the paravertebral muscle on the concave side had a significant increase at the final follow-up (p < 0.05). The elasticity of the paravertebral muscle on the convex side also increased at the upper end (p < 0.05). The elasticity asymmetry of the deep fascia decreased, but the elasticity asymmetry of the paravertebral muscle increased at the upper end of the curve (p < 0.05). INTERPRETATION The paravertebral muscle on the concave side is stiffer after surgery. Elastic asymmetry of paravertebral muscle increased and elastic asymmetry of the deep fascia decreased at the upper end of the curvature. Further study is needed to elucidate the mechanism by which the paravertebral soft tissue responds after surgery.
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Affiliation(s)
- Aixing Pan
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Wen Cao
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Bingchao Wu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Li Yin
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Hongtao Ding
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Ruijun Guo
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Yuzeng Liu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
| | - Lijin Zhou
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
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Kim HJ, Yang JH, Chang DG, Suk SI, Suh SW, Kim JS, Kim SI, Song KS, Cho W. Incidence and Radiological Risk Factors of Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis Following Pedicle Screw Instrumentation with Rod Derotation and Direct Vertebral Rotation: A Minimum 5-Year Follow-Up Study. J Clin Med 2021; 10:jcm10225351. [PMID: 34830634 PMCID: PMC8617806 DOI: 10.3390/jcm10225351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 12/11/2022] Open
Abstract
Several studies have reported incidence and risk factors for the development of proximal junctional kyphosis (PJK) in patients with adolescent idiopathic scoliosis (AIS). However, there is little information regarding long-term follow-up after pedicle screw instrumentation (PSI) with rod derotation (RD) and direct vertebral rotation (DVR). Sixty-nine AIS patients who underwent deformity correction using PSI with RD and DVR were retrospectively analyzed in two groups according to the occurrence of PJK, with a minimum five-year follow-up, including a non-PJK group (n = 62) and PJK group (n = 7). Radiological parameters were evaluated at preoperative, postoperative, and last follow-up. Incidence for PJK was 10.1% (7/69 patients), with a mean 9.4-year follow-up period. The thoracolumbar/lumbar curve (TL/L curve) was proportionally higher in the PJK group. The proximal compensatory curve was significantly lower in the PJK group than in the non-PJK group preoperatively (p = 0.027), postoperatively (p = 0.001), and at last follow-up (p = 0.041). The development of PJK was associated with the TL/L curve pattern, lower preoperative proximal compensatory curve, and over-correction of the proximal curve for PSI with RD and DVR. Therefore, careful evaluation of compensatory curves as well as of the main curve is important to prevent the development of PJK in the treatment of AIS.
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Affiliation(s)
- Hong Jin Kim
- Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea; (H.J.K.); (S.-I.S.); (J.S.K.)
| | - Jae Hyuk Yang
- Department of Orthopedic Surgery, College of Medicine, Korea University Guro Hospital, Korea University, Seoul 08308, Korea; (J.H.Y.); (S.W.S.)
| | - Dong-Gune Chang
- Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea; (H.J.K.); (S.-I.S.); (J.S.K.)
- Correspondence: ; Tel.: +82-2-950-1284
| | - Se-Il Suk
- Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea; (H.J.K.); (S.-I.S.); (J.S.K.)
| | - Seung Woo Suh
- Department of Orthopedic Surgery, College of Medicine, Korea University Guro Hospital, Korea University, Seoul 08308, Korea; (J.H.Y.); (S.W.S.)
| | - Ji Su Kim
- Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul 01757, Korea; (H.J.K.); (S.-I.S.); (J.S.K.)
| | - Sang-Il Kim
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Kwang-Sup Song
- Department of Orthopedic Surgery, College of Medicine, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea;
| | - Woojin Cho
- Montefiore Medical Center, Department of Orthopedic Surgery, Albert Einstein College of Medicine, Bronx, NY 10467, USA;
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