The recovery of damaged paraspinal muscles by posterior surgical treatment for patients with lumbar degenerative diseases and its clinical consequence

Article type: Research Article

Authors: Cha, Jae-Ryong^a | Kim, Yong-Chan^{b; *} | Yoon, Wan-Keun^b | Lee, Won-Gyu^b | Kim, Tae-Hwan^c | Oh, Jae-Keun^c | Kim, Seok-Woo^c | Ohn, Suk Hoon^d | Cui, Ji Hao^e

Affiliations: [a] Department of Orthopaedic Surgery, Ulsan University Hospital, College of Medicine, Ulsan University, Ulsan, Korea | [b] Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea | [c] Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University, Dongan-gu, Anyang-si, Korea | [d] Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Hallym University, Dongan-gu, Anyang-si, Korea | [e] Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China

Correspondence: [*] Corresponding author: Yong-Chan Kim, Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea. Tel.: +82 2 440 6123; Fax: +82 2 440 7494; E-mail:yckimspine@gmail.com

Abstract: BACKGROUND: Posterior lumbar surgery can lead to damage on paraspinal muscles. OBJECTIVE: Our study aimed to examine the recovery in the denervated paraspinal muscles by posterior lumbar surgery and to determine that of improvement in the lower back pain (LBP). METHODS: Depending on surgical treatments, the patients were divided into two groups: The group I (interspinous implantation with decompression) and II (posterior lumbar interbody fusion with decompression). The paraspinal mapping score was recorded for individual muscle. RESULTS: In the group I, there was reinnervation in the denervated multifidus and erector spinae at the upper, surgical and lower levels at 12 months. In the group II, there was reinnervation in the denervated erector spinae at the upper, surgical and lower levels at 12 months. There was significant aggravation in the LBP in both groups at immediate postoperative. But there was significant improvement in it at 6 months in the group I and at 12 months in the group II. CONCLUSION: There was reinnervation in not only denervated multifidus and erector spinae at 12 months following interspinous ligament stabilization but also in denervated erector spinae at 12 months following pedicle screw fixation with fusion.

Keywords: Degenerative lumbar disease, paraspinal muscle, denervation, recovery

DOI: 10.3233/BMR-150455

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 4, pp. 801-809, 2017