Fatty Infiltration of Cervical Spine Extensor Musculature

• DOI: 10.1097/bsd.0000000000000742
• Publication Date: 2018-10-26T20:13:23Z
• Authors: Peter G. Passias; Frank A. Segreto; Cole A. Bortz; Samantha R. Horn; Nicholas J. Frang...; Bassel G. Diebo; Aaron Hockley; Charles Wang; Nicholas Shepard; Renaud Lafage; Virginie Lafage
• Keywords: Cobb angle

Study Design: This is a retrospective review of single surgeon cervical deformity (CD) database. Objective: Quantitatively describe the extensor musculature in CD population, and delineate associations between posterior atrophy progressive sagittal deformity. Summary Background Data: While fatty infiltration (FI; ie, atrophy) lumbar has been associated with pain deformity, little known relationship FI, CD, alignment, functionality. Methods: patients [TS-CL>20 degrees, C2–C7 Cobb>10 CL>10 vertical axis (cSVA)>4 cm, or chin-brow angle>25 degrees] 18 years old above, undergoing spinal fusion, baseline T2-weighted magnetic resonance images were included. FI was assessed using dedicated imaging software at each intervertebral level from C2–C7. gauged as ratio fat-free muscle cross-sectional area over total area, lower values indicating increasing FI. Influence BL on patient-reported outcome measures (PROMs) alignment investigated. Multiple linear regression analysis (covariates: age, sex, body mass index, ratio) determined predictors postoperative PROMs. Results: Thirty-eight included (age: 56.6, sex: 73.7% female, index: 30.1, Charlson Comorbidity Index 0.61). presentation: TS–CL 27.4 CL 2.1 cSVA: 27.2 mm. Mean 0.65±0.11. Worsening malaligned cSVA ( r s =0.389, P =0.019), T1SS =0.340, =0.062), impaired gait =0.358, =0.078). not PROMs >0.05). Following surgical intervention, models strongest predictor 1-year (β=−0.482, =0.007, R 2 =0.317). No PROMS parameters observed Conclusions: Patients significant demonstrate alterations spine. Atrophic changes these groups worsening an important alignment. Level Evidence: III.