ArticleBMC musculoskeletal disorders2022
Fat infiltration of paraspinal muscles as an independent risk for bone nonunion after posterior lumbar interbody fusion.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 22 citations in OpenAlex.
- Does pre-operative psoas muscle cross-sectional area predict post-operative outcomes following lumbar spine fusion surgery?-a systematic review and narrative synthesis.Journal of spine surgery (Hong Kong) · 2026Review
- Article
- Diagnostic Perspectives on the Relationship Between Paraspinal Muscles and Bone Mineral Density: A Narrative Review.Diagnostics (Basel, Switzerland) · 2026Review
- Clinical significance and future applications of standardized imaging parameters for assessing paraspinal muscle fatty infiltration in lumbar degenerative disease: a narrative review.Journal of orthopaedic surgery and research · 2026Review
- Paraspinal muscle fatty infiltration is associated with nonunion and cage subsidence after anterolateral lumbar interbody fusion: a level-specific analysis.Scientific reports · 2026Article
- Impact of preoperative lumbar paraspinal muscle quality on the prognosis of open pedicle screw fixation for thoracolumbar fractures.Frontiers in surgery · 2026Article
- Article
- Fatty infiltration in the multifidus predicts screw-loosening following short-segment decompression and fusion: proof of why we should protect and rehabilitate the paraspinal muscles.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Paraspinal Muscle Fat Infiltration as a Key Predictor of Symptomatic Intravertebral Vacuum Cleft: A Machine Learning Approach.Journal of clinical medicine · 2025Article
- Muscle fat infiltration: a narrative review of the magnetic resonance (MR)-based evaluation methods and their clinical applications.Quantitative imaging in medicine and surgery · 2024Review
- Impact of Postoperative Bracing Following Spinal Fusion for Degenerative Lumbar Conditions: An Updated Meta-Analysis of Randomized Controlled Trials.International journal of spine surgery · 2024Article
- Prediction of Subsequent Vertebral Fracture After Acute Osteoporotic Fractures from Clinical and Paraspinal Muscle Features.Calcified tissue international · 2024Article
- Georg Schmorl Prize of the German Spine Society (DWG) 2023: the influence of sarcopenia and paraspinal muscle composition on patient-reported outcomes: a prospective investigation of lumbar spinal fusion patients with 12-month follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Fatty Infiltration of Multifidus Muscles: An Easily Overlooked Risk Factor for the Severity of Osteoporotic Vertebral Fractures.Orthopaedic surgery · 2024Article
- The association between morphological characteristics of paraspinal muscle and spinal disorders.Annals of medicine · 2023Review
- Differences in lumbar paraspinal muscle morphology in patients with sagittal malalignment undergoing posterior lumbar fusion surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prognosis value of paraspinal muscle degeneration on clinical outcomes has been revealed. However no study has investigated the effect of the fat infiltration (FI) of paraspinal muscles on bone nonunion after posterior lumbar interbody fusion (PLIF).
methodsThree hundred fifty-one patients undergoing PLIF for lumbar spinal stenosis with 1-year follow-up were retrospectively identified. Patients were categorized into bone union (n = 301) and bone nonunion (n = 50) groups based on dynamic X-ray at 1-year follow-up. The relative total cross-sectional area (rTCSA) and FI of multifidus (MF) and erector spinae (ES), and the relative functional CSA (rFCSA) of psoas major (PS) were measured on preoperative magnetic resonance imaging.
resultsThe nonunion group had a significantly higher MF FI and a higher ES FI and a smaller MF rTCSA than the union group (p = 0.001, 0.038, 0.026, respectively). Binary logistic regression revealed that MF FI (p = 0.029, odds ratio [OR] = 1.04), lumbosacral fusion (p = 0.026, OR = 2193) and length of fusion (p = 0.001, OR = 1.99) were independent factors of bone nonunion. In subgroup analysis, in one or two-level fusion group, the patients with nonunion had a higher MF FI and a higher ES FI than those of the patients with union (all p < 0.05). Similarly, in lumbosacral fusion group, the patients with nonunion had a higher MF FI and a higher ES FI than those of the patients with union (all p < 0.05). The logistic regressions showed that MF FI remained an independent factor of bone nonunion both in the patients with one or two-level fusion (p = 0.003, OR = 1.074) and in the patients with lumbosacral fusion (p = 0.006, OR = 1.073).
conclusionsHigher fatty degeneration was strongly associated with bone nonunion after PLIF. Surgeons should pay attention to the FI of paraspinal muscles when performing posterior surgery for patients, especially those who need short-segment fusion or to extend fusion to S1.
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