PMID- 35671940 OWN - NLM STAT- MEDLINE DCOM- 20221004 LR - 20221027 IS - 1878-1632 (Electronic) IS - 1529-9430 (Linking) VI - 22 IP - 10 DP - 2022 Oct TI - Association between muscle health and patient-reported outcomes after lumbar microdiscectomy: early results. PG - 1677-1686 LID - S1529-9430(22)00239-X [pii] LID - 10.1016/j.spinee.2022.05.013 [doi] AB - BACKGROUND CONTEXT: Poor muscle health has been implicated as a source of back pain among patients with lumbar spine pathology. Recently, a novel magnetic resonance imaging (MRI)-based lumbar muscle health grade was shown to correlate with health-related quality of life scores. However, the impact of muscle health on postoperative functional outcomes following spine surgery remains to be investigated. PURPOSE: To determine whether muscle health grade measured by preoperative psoas and paralumbar muscle cross-sectional areas impact the achievement of minimal clinically important difference (MCID) following lumbar microdiscectomy. STUDY DESIGN/SETTING: Retrospective cohort study. PATIENT SAMPLE: Consecutive patients who underwent 1-level lumbar microdiscectomy in a single institution between 2017 and 2021. OUTCOME MEASURES: Rate of MCID achievement, time to MCID achievement, PROMs including Oswestry Disability Index (ODI), visual analog scale for back pain (VAS back), VAS leg, Short Form 12 Physical Component Summary (SF-12 PCS), SF-12 Mental Component Summary (SF-12 MCS), and Patient Reported Outcomes Measurement Information System Physical Function (PROMIS PF). METHODS: Two previously validated methods for muscle health grading were applied. Axial T2 MRI were analyzed for muscle measurements. The psoas-based method utilized the normalized total psoas area (NTPA), which is the psoas cross-sectional area divided by the square of patient height (mm(2)/m(2)). Patients were divided into low and high NTPA groups based on sex-specific lowest quartile NTPA thresholds. The paralumbar-based method incorporated the paralumbar cross-sectional area normalized by body mass index (PL-CSA/BMI) and Goutallier classification. Score of 1 was added for either PL-CSA/BMI >130 or Goutallier class of /=1. Poor paralumbar muscle health was associated with older age, female sex, higher BMI, and CCI >/=1. There were no differences in rates of MCID achievement for any PROMs between low versus high NTPA groups or between poor versus good paralumbar groups. Low NTPA was associated with longer time to MCID achievement for ODI, VAS back, VAS leg, and SF-12 MCS. Poor paralumbar muscle health was associated with longer time to MCID achievement for VAS back, VAS leg, and SF-12 PCS. NTPA negatively correlated with change in VAS back (6-week, 12-week) and VAS leg (6-month). PL-CSA/BMI positively correlated with change in PROMIS-PF at 3 months follow-up. CONCLUSIONS: Among patients undergoing lumbar microdiscectomy, patients with worse muscle health grades achieved MCID at similar rates but required longer time to achieve MCID. Lower NTPA was weakly correlated with larger improvements in pain scores. PL-CSA/BMI positively correlated with change in PROMIS-PF. Our findings suggest that with regards to functional outcomes, patients with worse muscle health may take longer to recuperate postoperatively compared to those with better muscle health. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Song, Junho AU - Song J AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Araghi, Kasra AU - Araghi K AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Dupont, Marcel M AU - Dupont MM AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Shahi, Pratyush AU - Shahi P AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Bovonratwet, Patawut AU - Bovonratwet P AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Shinn, Daniel AU - Shinn D AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Dalal, Sidhant S AU - Dalal SS AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Melissaridou, Dimitra AU - Melissaridou D AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Virk, Sohrab S AU - Virk SS AD - Northwell Health Long Island Jewish Medical Center, 270-05 76th Ave, Queens, NY 10040, USA. FAU - Iyer, Sravisht AU - Iyer S AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Dowdell, James E AU - Dowdell JE AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Sheha, Evan D AU - Sheha ED AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. FAU - Qureshi, Sheeraz A AU - Qureshi SA AD - Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA. Electronic address: sheerazqureshimd@gmail.com. LA - eng GR - UL1 TR002384/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20220606 PL - United States TA - Spine J JT - The spine journal : official journal of the North American Spine Society JID - 101130732 SB - IM MH - Back Pain/surgery MH - Female MH - Humans MH - Lumbar Vertebrae/surgery MH - Male MH - Muscles MH - Patient Reported Outcome Measures MH - Quality of Life MH - Retrospective Studies MH - *Spinal Fusion/methods MH - Treatment Outcome OTO - NOTNLM OT - Lumbar OT - MCID OT - Microdiscectomy OT - Muscle health OT - Paralumbar OT - Patient-reported outcomes OT - Psoas COIS- Declaration of Competing Interest The authors report no conflicts of interest relevant to the topic of this study. EDAT- 2022/06/08 06:00 MHDA- 2022/10/05 06:00 CRDT- 2022/06/07 19:26 PHST- 2022/02/28 00:00 [received] PHST- 2022/05/05 00:00 [revised] PHST- 2022/05/26 00:00 [accepted] PHST- 2022/06/08 06:00 [pubmed] PHST- 2022/10/05 06:00 [medline] PHST- 2022/06/07 19:26 [entrez] AID - S1529-9430(22)00239-X [pii] AID - 10.1016/j.spinee.2022.05.013 [doi] PST - ppublish SO - Spine J. 2022 Oct;22(10):1677-1686. doi: 10.1016/j.spinee.2022.05.013. Epub 2022 Jun 6.