The influence of posterior lumbar interbody fusion on paraspinal muscle injury

doi:10.11958/20221658

Abstract

Abstract:

Objective To evaluate paraspinal muscle injury after posterior midline lumbar interbody fusion. Methods Fifty-six patients with lateral recess lumbar spinal stenosis who received PLIF were prospectively included. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were recorded before surgery and 3 months after surgery. Surface electromyography (sEMG) was used to measure the root mean square (RMS) and median frequency (MF) of paravertebral muscle in the three stages of lift test. Serum levels of creatine kinase (CK) and C-reactive protein (CRP) were detected before surgery and at 1, 3 and 7 days after surgery. Results The VAS score and ODI score were significantly lower in patients 3 months after surgery than those before surgery (P<0.05). In test stage 1 and 2, the level of paraspinal muscle RMS was significantly lower 3 months after surgery than that before surgery, and in test stage 3, the postoperative paraspinal muscle MF value was significantly higher than that before surgery (P<0.05). Serum CK level was significantly higher on the 1st and 3rd day after surgery than that before surgery, and which reached the peak on the 1st day after surgery (P<0.05). Serum CK level basically recovered to the preoperative level on the 7th day after surgery, and CRP level was higher at all time points after surgery than that before surgery, and reached the peak on the 3rd day after surgery, and decreased on the 7th day after surgery (P<0.05). Conclusion sEMG reveals that posterior lumbar interbody fusion causes some paraspinal muscle tissue injury, which may be the primary cause of postoperative paraspinal muscle function decline and postoperative low back pain.

Key words: spinal stenosis, lumbar vertebrae, spinal fusion, creatine kinase, electromyography, paraspinal muscles

CLC Number:

R681.5

Figures/Tables 2

References 22

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测试阶段	术前	术后3个月	t
阶段一RMS值（μV）	16.44±6.26	9.37±3.34	10.301^*
阶段二RMS值（μV）	43.58±15.39	24.87±7.96	11.122^*
阶段三MF值（Hz）	62.68±23.86	74.82±25.44	3.535^*

测试阶段	术前	术后3个月	t
阶段一RMS值（μV）	16.44±6.26	9.37±3.34	10.301^*
阶段二RMS值（μV）	43.58±15.39	24.87±7.96	11.122^*
阶段三MF值（Hz）	62.68±23.86	74.82±25.44	3.535^*

时间	CK（U/L）	CRP（mg/L）
术前	69.46±18.73	1.73±0.84
术后第1天	284.98±108.18^a	32.17±16.95^a
术后第3天	156.29±56.72^ab	79.06±31.12^ab
术后第7天	76.05±27.36^bc	21.58±12.38^abc
F	89.180^**	145.857^**

时间	CK（U/L）	CRP（mg/L）
术前	69.46±18.73	1.73±0.84
术后第1天	284.98±108.18^a	32.17±16.95^a
术后第3天	156.29±56.72^ab	79.06±31.12^ab
术后第7天	76.05±27.36^bc	21.58±12.38^abc
F	89.180^**	145.857^**