Higher Paraspinal Muscle Density Effect on Outcomes After Anterior Cervical Discectomy and Fusion. Issue 6 (July 2021)

• Record Type: Journal Article
• Authors: Pinter, Zachariah W.; Wagner, Scott C.; Fredericks, Donald R.; Xiong, Ashley; Freedman, Brett A.; Elder, Benjamin D.; Nassr, Ahmad; Bydon, Mohamad; Kepler, Christopher K.; Sebastian, Arjun S.
• Is Part Of: Global spine journal. Volume 11:Issue 6(2021)
• Page Start: 931
• Page End: 935
• Publication Date: 2021-07
• Subjects: sarcopenia -- paraspinal muscle -- Goutalier grade -- anterior cervical discectomy and fusion -- ACDF; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1177/2192568220935108
• Languages: English
• ISSNs: 2192-5682

Abstract

Study Design: Retrospective cohort study. Objectives: Studies in the lumbar spine suggest a correlation between sarcopenia and worse patient outcomes. The purpose of this study was to determine whether paraspinal Goutalier grade of fat degeneration is associated with patient-reported outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods: We performed a retrospective review of a prospective cohort of patients undergoing 1- to 3-level ACDF at a single institution between the years 2011-2014. We utilized preoperative magnetic resonance images to classify patients into Goutalier grades. Patient-reported outcomes, including Neck Disability Index (NDI), RAND score, and EQ-5D score were collected and analyzed according to patients' Goutalier grade. Results: We identified 69 patients for inclusion. A total of 29 patients were classified as Goutalier 0-1 (group 1), 29 were Goutalier 1.5-2 (group 2), and 11 were Goutalier 2.5-4.0 (group 3). All Goutalier groups experienced significant improvement in all 3 outcome scores. Average postoperative NDI scores were 25.3 in group 1, 13.9 in group 2, and 25.1 in group 3 ( P = .02). The percentage of patients in each group reporting worse disability after surgery was 17.2%, 3.3%, and 9.1%, respectively ( P = .05). No statistically significant difference was seen between groups in postoperative EQ-5D ( P = .07) or RAND scores ( P > .05). Conclusions: The present study is the first to assess the association between cervical paraspinal muscle Goutalier grade and patient-reported outcomes following ACDF. Based on our study, patients with worse cervical paraspinal degeneration may benefit from improved symptom relief in comparison to patients with a lesser degree of degeneration undergoing ACDF.