ArticleThe spine journal : official journal of the North American Spine Society2025
Normalized total psoas area predicts early postoperative mobility and perioperative adverse events after adult spinal deformity surgery.
Article in The spine journal : official journal of the North American Spine Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Radiographic paraspinal muscle size in adult spinal deformity: a systematic review and meta-analysis.Spine deformity · 2026Pooled it
- Latent profile analysis of multidimensional muscle profiles versus traditional sarcopenia metrics for capturing sagittal malalignment in adult spinal deformity: a retrospective study.Asian spine journal · 2026Article
- Impact of Paraspinal Muscle Characteristics on the Risk of Symptomatic Epidural Hematoma Following Transforaminal Lumbar Interbody Fusion.Global spine journal · 2026Article
- Psoas muscle attenuation on preoperative CT predicts 30-day complications after lateral lumbar interbody fusion.Brain & spine · 2026Article
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16 authors.
Funding
Abstract
background contextPoor muscle health has been shown to predict poor perioperative outcomes following adult spinal deformity (ASD) surgery. Currently, there is limited data concerning the correlation between muscle health and recovery among patients undergoing ASD surgery. PURPOSE: To determine the relationship between normalized total psoas area (NTPA), postoperative mobility and adverse events (AEs) among patients undergoing ASD surgery. STUDY
designRetrospective cohort study. PATIENT SAMPLE: A retrospective analysis was performed at a single institution between January 2014 and December 2023 of patients undergoing ASD surgery by 10 board certified fellowship-trained orthopaedic spine surgeons. OUTCOME MEASURES: Primary outcome measures were postoperative ambulation distance on postoperative day (POD) 1, 2, 3, and 4 as well as perioperative adverse events including postoperative anemia requiring transfusion, ileus, urinary retention wound complication including dehiscence and infection, delirium, atelectasis, urinary tract infection (UTI), deep vein thrombosis (DVT), and epidural hematoma. Secondary outcome measures were 30-day reoperation rates, 30-day readmission rates, and postoperative length of stay (LOS).
methodsPatients that underwent ASD surgery at a single center (2014-2023) were included in the study. NTPA was analyzed at the L3 and L4 midvertebral body on preoperative magnetic resonance imaging (MRI). Receiver operating characteristic (ROC) curve analysis was used to determine gender-specific NTPA cut-off values for predicting perioperative AEs. Patients were categorized as having a low NTPA if both L3 and L4 NTPA were below the cut-off values. Multivariate logistic regression was conducted to identify confounding predictors of perioperative AEs.
results279 patients (102 males, 177 females, mean age 61.2±15.2 years) were included. ROC curve analysis demonstrated L3 NTPA <805 mm
conclusionsLow L3 and L4 NTPA is associated with lower early postoperative mobility and higher rates of perioperative AEs among patients undergoing ASD surgery. These findings stress the importance of muscle health in recovery after ASD surgery.
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