Erector spinae muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach.
Spine, 2007
Erector spinae muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach.
OBJECTIVES: To quantify MRI changes of the erector spinae following lumbar surgery through a posterior approach and the possible protection of these muscles during surgery by the use of cholinergic blockade.
SUMMARY OF BACKGROUND DATA: It has been shown that lumbar spine surgery through a posterior approach can induce iatrogenic lesions in the erector spinae.
We have shown in a previous study that histologic changes on muscular biopsy performed in the multifidus at the end of the surgical procedure were not modified by the use of cholinergic blockade during surgery.
METHODS: Twenty patients scheduled to undergo pedicle-screw enhanced L4-L5 arthrodesis were enrolled in this study.
The 2 slices immediately proximal and distal to the pedicle screw construct on the postoperative MRI were selected.
The contractile component of the cross-sectional area (CCSA) was calculated from the number of pixels surrounded and the signal intensity of each pixel.
RESULTS: There was only slight changes in the erector spinae CCSA proximal to a posterior lumbar arthrodesis.
CONCLUSIONS: Erector spinae muscle alterations mainly occur distal to posterior lumbar surgical procedures.
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