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Lumbar spinal fusion linked with more paraspinal muscle atrophy vs decompression alone
Researchers found significantly higher postoperative volumetric paraspinal muscle atrophy with lumbar spine fusion, posterior procedures and non-minimally invasive fusion compared with decompression alone.
The systematic review of the literature included 12 studies and a total of 529 patients, with 365 patients who underwent lumbar spine fusion and 164 who underwent lumbar decompression without fusion. Researchers noted the mean postoperative volumetric paraspinal muscle atrophy (PMA) was significantly higher in the fusion cohort compared with the non-fusion cohort. In addition, when fusion outcomes were substratified according to minimally invasive (MIS) fusion compared with non-MIS fusion, the mean postoperative PMA was significantly lower in MIS fusion group.
“When posterior non-fusion outcomes (i.e., lumbar laminectomies/discectomies) were substratified according to MIS decompression and non-MIS decompression, there were no significant differences in the mean PMA (8.6%±4.3% vs. 9.4%±10.2%, respectively),” researchers wrote in the study.
The researchers concluded anterior lumbar procedures result in less PMA than equivalent posterior procedures and there may be less postoperative PMA in MIS fusion compared with non-MIS fusion. – by Robert Linnehan
Disclosures: Pourtaheri reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.