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KMID : 1145220210180030495
Neurospine
2021 Volume.18 No. 3 p.495 ~ p.503
Correlation of Paraspinal Muscle Mass With Decompensation of Sagittal Adult Spinal Deformity After Setting of Fatigue Post 10-Minute Walk
Bae Jun-Seok

Sathe Ashwin
Lee Shih-Min
Theologis Alexander A.
Deviren Vedat
Lee Sang-Ho
Abstract
Objective: The purpose of this study was to investigate the changes in spinopelvic parameters before and after the setting of muscle fatigue along with its correlation with pre-existing paraspinal and psoas muscle mass.

Methods: Single-center retrospective review of prospectively collected data was conducted on 145-adults with symptomatic loss of lumbar lordosis (LL). Radiographs were taken before and after walking for 10 minutes. Magnetic resonance imaging was used to calculate paraspinal muscle (PSM) cross-sectional area (CSA), mean signal intensity, fatty infiltration (FI), and lean muscle mass at thoracolumbar junction (T12) and lower lumbar level (L4). Psoas CSA was calculated at L3. Patients were divided into 2 groups namely compensated sagittal deformity (CSD) (SVA¡Â4 cm, PT>20¡Æ) and decompensated sagittal deformity (DSD) (SVA>4 cm, PT>20¡Æ) based on prewalk measurements.

Results: Initial mean SVA was 1.8 cm and 11 cm for CSD and DSD respectively (p < 0.01). After walking, significant deteriorations in SVA, PT?LL (p < 0.01) were observed in CSD without significant change in thoracic kyphosis (TK). All sagittal parameters in DSD deteriorated significantly. DSD group had significantly poorer PSM quality at T12 and L4 compared to CSD group. In CSD group, sagittal decompensation correlated with muscle quality, i.e., decreases in LL (¥ÄLL) correlated with CSA of PSM/vertebral body (VB) at L4 (r=-0.412, p=0.046) while increases in TK (¥ÄTK) correlated with CSA of PSM/VB at T12 (r=0.477, p=0.018). ¥ÄSVA and ¥ÄPT correlated with FI at L4 (r=0.577, p=0.003 and r=-0.407, p=0.048, respectively). DSD group, had weak correlations (-0.3
Conclusion: PSM quality in adults with spinal deformity correlates with patients¡¯ ability to maintain an upright posture and sagittal decompensation after walking for 10 minutes.
KEYWORD
Deformity, Kyphosis, Fatigue, Paraspinal muscles
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