{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T08:35:10Z","timestamp":1794126910705,"version":"4.8.0"},"reference-count":51,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>This study aimed to quantify pre- and postoperative paraspinal muscular variation following posterior lumbar interbody fusion (PLIF) in patients with degenerative lumbar spinal stenosis (DLSS) and measure the association of this variation with adjacent-segment degeneration (ASD).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Data from 149 patients who underwent L4\u2013S1 PLIF for DLSS were collected. Patients were divided into radiologically confirmed ASD and control groups according to follow-up radiological findings. MRI was performed before surgery and at the last follow-up. Muscular parameters including the relative cross-sectional area (rCSA), relative functional cross-sectional area (rFCSA), relative total cross-sectional area (rTCSA), and fatty infiltration (FI) of the multifidus (MF), erector spinae (ES), and psoas major (PM) muscles were measured on preoperative and follow-up L2\u2013S1 MR images. Logistic regression was used to investigate risk factors for ASD.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The rate of radiological ASD was 42.3% at the final follow-up (mean 25.71 \u00b1 8.35 months). At surgical levels, the rFCSA and rTCSA of the MF and ES muscles decreased. The FI of the MF from L2\u20133 to L5\u2013S1 and ES muscles at L5\u2013S1 significantly increased after surgery, while the rFCSA and rTCSA of the PM muscle increased and its FI decreased. At adjacent levels, the rFCSA and rTCSA of the MF muscle and rTCSA of the ES muscle decreased and the FI of the MF muscle increased postoperatively (p &lt; 0.05), but the rFCSA and rTCSA of the PM muscle increased and its FI decreased (p &lt; 0.05). The FIs of the MF, ES, and PM muscles at adjacent levels significantly differed between the ASD and control groups. Logistic regression analysis indicated that higher BMI (p = 0.002) and FI of the PM muscle at adjacent levels (p = 0.025) were significant risk factors for ASD.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The functional area decreased in the MF and ES muscles and increased in the PM muscle after L4\u2013S1 PLIF. A compensatory postoperative decrease in FI of the PM muscle at the adjacent level was a protective factor for ASD in DLSS patients after PLIF.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.11.spine23750","type":"journal-article","created":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T01:44:56Z","timestamp":1706319896000},"page":"551-561","source":"Crossref","is-referenced-by-count":13,"title":["Relationship between the postoperative variations of paraspinal muscles and adjacent-segment degeneration in patients with degenerative lumbar spinal stenosis after posterior instrumented lumbar fusion"],"prefix":"10.3171","volume":"40","author":[{"given":"Fei","family":"Xu","sequence":"first","affiliation":[{"name":"Orthopaedic Department, Peking University Third Hospital, Beijing, China;"},{"name":"Peking University Health Science Center, Beijing, China;"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, China; and"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Peking University Third Hospital, Beijing, China;"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, China; and"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoran","family":"Sun","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Peking University Third Hospital, Beijing, China;"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, China; and"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Jiang","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Peking University Third Hospital, Beijing, China;"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, China; and"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengyu","family":"Han","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Peking University Third Hospital, Beijing, China;"},{"name":"Peking University Health Science Center, Beijing, China;"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, China; and"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weishi","family":"Li","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Peking University Third Hospital, Beijing, China;"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, China; and"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"13","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"1484","article-title":"Five-year outcomes of surgical treatment for degenerative lumbar spinal stenosis: a prospective observational study of symptom severity at standard intervals after surgery","volume":"31","author":"Yamashita K","year":"2006","unstructured":"Yamashita K, Ohzono K, Hiroshima K. Five-year outcomes of surgical treatment for degenerative lumbar spinal stenosis: a prospective observational study of symptom severity at standard intervals after surgery. Spine (Phila Pa 1976). 2006;31(13):1484\u20131490."},{"issue":"3","key":"b2","series-title":"Eur Spine J","first-page":"411","article-title":"Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry","volume":"21","author":"Sobottke R","year":"2012","unstructured":"Sobottke R, Aghayev E, R\u00f6der C, Eysel P, Delank SK, Zweig T. Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry. Eur Spine J. 2012;21(3):411\u2013417."},{"issue":"9","key":"b3","series-title":"Spine J","first-page":"1528","article-title":"Trailblazing: the historical development of the posterior lumbar interbody fusion (PLIF)","volume":"21","author":"Fenton-White HA","year":"2021","unstructured":"Fenton-White HA. Trailblazing: the historical development of the posterior lumbar interbody fusion (PLIF). Spine J. 2021;21(9):1528\u20131541."},{"issue":"2","key":"b4","series-title":"Orthopedics","first-page":"e209","article-title":"Paraspinal muscle atrophy after lumbar spine surgery","volume":"39","author":"Pourtaheri S","year":"2016","unstructured":"Pourtaheri S, Issa K, Lord E,  Paraspinal muscle atrophy after lumbar spine surgery. Orthopedics. 2016;39(2):e209\u2013e214."},{"issue":"2","key":"b5","series-title":"Asian Spine J","first-page":"89","article-title":"The quantitative analysis of back muscle degeneration after posterior lumbar fusion: comparison of minimally invasive and conventional open surgery","volume":"3","author":"Min SH","year":"2009","unstructured":"Min SH, Kim MH, Seo JB, Lee JY, Lee DH. The quantitative analysis of back muscle degeneration after posterior lumbar fusion: comparison of minimally invasive and conventional open surgery. Asian Spine J. 2009;3(2):89\u201395."},{"issue":"3","key":"b6","series-title":"Neurol Med Chir (Tokyo)","first-page":"151","article-title":"Postoperative changes in paraspinal muscle thickness after various lumbar back surgery procedures","volume":"40","author":"Suwa H","year":"2000","unstructured":"Suwa H, Hanakita J, Ohshita N, Gotoh K, Matsuoka N, Morizane A. Postoperative changes in paraspinal muscle thickness after various lumbar back surgery procedures. Neurol Med Chir (Tokyo). 2000;40(3):151\u2013155."},{"issue":"1","key":"b7","series-title":"Sci Rep","first-page":"14635","article-title":"Comparison of paraspinal muscle degeneration and decompression effect between conventional open and minimal invasive approaches for posterior lumbar spine surgery","volume":"10","author":"Fu CJ","year":"2020","unstructured":"Fu CJ, Chen WC, Lu ML, Cheng CH, Niu CC. Comparison of paraspinal muscle degeneration and decompression effect between conventional open and minimal invasive approaches for posterior lumbar spine surgery. Sci Rep. 2020;10(1):14635."},{"issue":"1","key":"b8","series-title":"BMC Musculoskelet Disord","first-page":"73","article-title":"Paraspinal muscle changes after single-level posterior lumbar fusion: volumetric analyses and literature review","volume":"21","author":"Cho SM","year":"2020","unstructured":"Cho SM, Kim SH, Ha SK,  Paraspinal muscle changes after single-level posterior lumbar fusion: volumetric analyses and literature review. BMC Musculoskelet Disord. 2020;21(1):73."},{"issue":"1","key":"b9","series-title":"J Neurosurg Spine","first-page":"25","article-title":"Postoperative posterior lumbar muscle changes and their relationship to segmental motion preservation or restriction: a randomized prospective study","volume":"24","author":"Strube P","year":"2016","unstructured":"Strube P, Putzier M, Streitparth F, Hoff EK, Hartwig T. Postoperative posterior lumbar muscle changes and their relationship to segmental motion preservation or restriction: a randomized prospective study. 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Man Ther. 2008;13(4):349\u2013356."},{"issue":"23","key":"b30","series-title":"Spine (Phila Pa 1976)","first-page":"E1384","article-title":"Adjacent segment disease after single segment posterior lumbar interbody fusion for degenerative spondylolisthesis: minimum 10 years follow-up","volume":"43","author":"Okuda S","year":"2018","unstructured":"Okuda S, Nagamoto Y, Matsumoto T, Sugiura T, Takahashi Y, Iwasaki M. Adjacent segment disease after single segment posterior lumbar interbody fusion for degenerative spondylolisthesis: minimum 10 years follow-up. Spine (Phila Pa 1976). 2018;43(23):E1384\u2013E1388."},{"issue":"17","key":"b31","series-title":"Spine (Phila Pa 1976)","first-page":"1873","article-title":"Magnetic resonance classification of lumbar intervertebral disc degeneration","volume":"26","author":"Pfirrmann CW","year":"2001","unstructured":"Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001;26(17):1873\u20131878."},{"issue":"8","key":"b32","series-title":"Eur Spine J","first-page":"1758","article-title":"The use of CT Hounsfield unit values to identify the undiagnosed spinal osteoporosis in patients with lumbar degenerative diseases","volume":"28","author":"Zou D","year":"2019","unstructured":"Zou D, Li W, Deng C, Du G, Xu N. The use of CT Hounsfield unit values to identify the undiagnosed spinal osteoporosis in patients with lumbar degenerative diseases. Eur Spine J. 2019;28(8):1758\u20131766."},{"key":"b33","series-title":"J Orthop Surg Res","first-page":"97","article-title":"Risk factors for predicting symptomatic adjacent segment degeneration requiring surgery in patients after posterior lumbar fusion","volume":"9","author":"Liang J","year":"2014","unstructured":"Liang J, Dong Y, Zhao H. Risk factors for predicting symptomatic adjacent segment degeneration requiring surgery in patients after posterior lumbar fusion. J Orthop Surg Res. 2014;9:97."},{"issue":"17","key":"b34","series-title":"Spine (Phila Pa 1976)","first-page":"1888","article-title":"Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling","volume":"31","author":"Hansen L","year":"2006","unstructured":"Hansen L, de Zee M, Rasmussen J, Andersen TB, Wong C, Simonsen EB. Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling. Spine (Phila Pa 1976). 2006;31(17):1888\u20131899."},{"issue":"3","key":"b35","series-title":"J Biomech","first-page":"339","article-title":"The psoas major muscle: a three-dimensional geometric study","volume":"28","author":"Santaguida PL","year":"1995","unstructured":"Santaguida PL, McGill SM. The psoas major muscle: a three-dimensional geometric study. J Biomech. 1995;28(3):339\u2013345."},{"issue":"5","key":"b36","series-title":"Spine (Phila Pa 1976)","first-page":"575","article-title":"Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome","volume":"18","author":"Sihvonen T","year":"1993","unstructured":"Sihvonen T, Herno A, Palj\u00e4rvi L, Airaksinen O, Partanen J, Tapaninaho A. Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome. Spine (Phila Pa 1976). 1993;18(5):575\u2013581."},{"issue":"3","key":"b37","series-title":"Eur Spine J","first-page":"193","article-title":"Density of lumbar muscles 4 years after decompressive spinal surgery","volume":"5","author":"Airaksinen O","year":"1996","unstructured":"Airaksinen O, Herno A, Kaukanen E, Saari T, Sihvonen T, Suomalainen O. Density of lumbar muscles 4 years after decompressive spinal surgery. 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PLoS One. 2019;14(4):e0214812."},{"issue":"1","key":"b40","series-title":"Spine (Phila Pa 1976)","first-page":"123","article-title":"Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation","volume":"30","author":"Kim DY","year":"2005","unstructured":"Kim DY, Lee SH, Chung SK, Lee HY. Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. Spine (Phila Pa 1976). 2005;30(1):123\u2013129."},{"key":"b41","series-title":"Int J Spine Surg","first-page":"25","article-title":"Quantification of multifidus atrophy and fatty infiltration following a minimally invasive microdiscectomy","volume":"9","author":"Tabaraee E","year":"2015","unstructured":"Tabaraee E, Ahn J, Bohl DD, Phillips FM, Singh K. Quantification of multifidus atrophy and fatty infiltration following a minimally invasive microdiscectomy. Int J Spine Surg. 2015;9:25."},{"issue":"1","key":"b42","series-title":"BMC Musculoskelet Disord","first-page":"1049","article-title":"The effect of posterior lumbar dynamic fixation and intervertebral fusion on paraspinal muscles","volume":"22","author":"Lin GX","year":"2021","unstructured":"Lin GX, Ma YM, Xiao YC,  The effect of posterior lumbar dynamic fixation and intervertebral fusion on paraspinal muscles. 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J Neurosurg Spine. 2019;32(2):155\u2013159."},{"key":"b44","series-title":"Front Bioeng Biotechnol","first-page":"718996","article-title":"Biomechanical evaluation of different surgical approaches for the treatment of adjacent segment diseases after primary anterior cervical discectomy and fusion: a finite element analysis","volume":"9","author":"Ke W","year":"2021","unstructured":"Ke W, Chen C, Wang B,  Biomechanical evaluation of different surgical approaches for the treatment of adjacent segment diseases after primary anterior cervical discectomy and fusion: a finite element analysis. Front Bioeng Biotechnol. 2021;9:718996."},{"issue":"4","key":"b45","series-title":"Neurosurgery","first-page":"396","article-title":"Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease","volume":"76","author":"Ou CY","year":"2015","unstructured":"Ou CY, Lee TC, Lee TH, Huang YH. Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease. Neurosurgery. 2015;76(4):396\u2013402."},{"issue":"6","key":"b46","series-title":"J Spinal Disord","first-page":"464","article-title":"Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders","volume":"8","author":"Aota Y","year":"1995","unstructured":"Aota Y, Kumano K, Hirabayashi S. Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders. J Spinal Disord. 1995;8(6):464\u2013473."},{"issue":"2","key":"b47","series-title":"Spine (Phila Pa 1976)","first-page":"E29","article-title":"Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements","volume":"27","author":"Moseley GL","year":"2002","unstructured":"Moseley GL, Hodges PW, Gandevia SC. 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Spine (Phila Pa 1976). 1996;21(22):2640\u20132650."},{"issue":"4","key":"b49","series-title":"J Orthop Sports Phys Ther","first-page":"218","article-title":"Treatment of iliopsoas syndrome with a hip rotation strengthening program: a retrospective case series","volume":"29","author":"Johnston CA","year":"1999","unstructured":"Johnston CA, Lindsay DM, Wiley JP. Treatment of iliopsoas syndrome with a hip rotation strengthening program: a retrospective case series. J Orthop Sports Phys Ther. 1999;29(4):218\u2013224."},{"key":"b50","series-title":"In: StatPearls. StatPearls Publishing;","article-title":"Osteopathic manipulative treatment: muscle energy and counterstrain procedure - psoas muscle procedures","author":"Eldemire F","year":"2023","unstructured":"Eldemire F, Goto KK. Osteopathic manipulative treatment: muscle energy and counterstrain procedure - psoas muscle procedures. In: StatPearls. 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