Journal of Korean Neurosurgical Society

  • 제53권3호
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  • Pages.174-179
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  • 2013
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Back Muscle Changes after Pedicle Based Dynamic Stabilization

  • Moon, Kyung Yun (Spine Center, Department of Neurosurgery, Ansan 21st Century Hospital) ;
  • Lee, Soo-Eon (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, Ki-Jeong (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Hyun, Seung-Jae (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Kim, Hyun-Jib (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Jahng, Tae-Ahn (Department of Neurosurgery, Seoul National University College of Medicine)
  • 투고 : 2012.08.30
  • 심사 : 2013.02.25
  • 발행 : 2013.03.28
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초록

Objective : Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. Methods : Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. Results : Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. Conclusion : Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.

키워드

참고문헌

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피인용 문헌

  1. Short-term effects of a dynamic neutralization system (Dynesys) for multi-segmental lumbar disc herniation vol.25, pp.5, 2016, https://doi.org/10.1007/s00586-015-4307-1
  2. Dynamic stabilization using the Dynesys system versus posterior lumbar interbody fusion for the treatment of degenerative lumbar spinal disease: a clinical and radiological outcomes-based meta-analysi vol.40, pp.1, 2016, https://doi.org/10.3171/2015.10.focus15426
  3. Clinical Correlation between Muscle Damage and Oswestry Disability Index Score after Open Lumbar Surgery: Does Open Surgery Reduces Functional Ability? vol.12, pp.3, 2013, https://doi.org/10.4184/asj.2018.12.3.518
  4. Early Impact of Postoperative Bracing on Pain and Quality of Life After Posterior Instrumented Fusion for Lumbar Degenerative Conditions: A Randomized Trial vol.43, pp.3, 2013, https://doi.org/10.1097/brs.0000000000002292