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Does pre-operative multifidus morphology on magnetic-resonance imaging predict clinical outcomes in adults with degenerative lumbar spine disease following surgical treatment? A systematic review
EANS Academy. Copley P. 09/26/19; 275944; EP02062
Mr. Philip C. Copley
Mr. Philip C. Copley

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Abstract
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Background: Low back pain (LBP) resulting from degenerative lumbar spondylosis (DLS) is a leading contributor to global disability. Changes in the morphology of the lumbar multifidus muscle on magnetic-resonance imaging (MRI) are associated with worse LBP and disability, but the association between multifidus morphology and post-operative outcomes is not known. The purpose of this systematic review is to examine the relationship between pre-operative multifidus morphology and post-operative changes in pain and disability.
Methods: We performed a systematic search using the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Scopus databases covering the period from January 1946 to January 2018. The literature was searched and assessed by independent reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. All relevant papers were assessed for risk of bias according to the Quality in Prognosis Studies (QUIPS) tool.
Results: The initial search yielded 436 studies, of which 6 studies were included in the analysis. Four studies were at a low risk of bias. These studies included a total of 873 patients undergoing spinal surgery. An association between low fat infiltration and greater improvement in LBP and disability following surgery was identified. There was insufficient evidence to identify a relationship between cross-sectional area (CSA) and LBP or disability.
Conclusions: This review provides evidence that patients undergoing surgery for management of degenerative lumbar spine disease have improved clinical outcomes if pre-operative multifidus muscle quality is higher.
Keywords: Low back pain · Degenerative lumbar disease · Multifidus morphology · Spinal surgery · Magnetic resonance imaging
Background: Low back pain (LBP) resulting from degenerative lumbar spondylosis (DLS) is a leading contributor to global disability. Changes in the morphology of the lumbar multifidus muscle on magnetic-resonance imaging (MRI) are associated with worse LBP and disability, but the association between multifidus morphology and post-operative outcomes is not known. The purpose of this systematic review is to examine the relationship between pre-operative multifidus morphology and post-operative changes in pain and disability.
Methods: We performed a systematic search using the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Scopus databases covering the period from January 1946 to January 2018. The literature was searched and assessed by independent reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. All relevant papers were assessed for risk of bias according to the Quality in Prognosis Studies (QUIPS) tool.
Results: The initial search yielded 436 studies, of which 6 studies were included in the analysis. Four studies were at a low risk of bias. These studies included a total of 873 patients undergoing spinal surgery. An association between low fat infiltration and greater improvement in LBP and disability following surgery was identified. There was insufficient evidence to identify a relationship between cross-sectional area (CSA) and LBP or disability.
Conclusions: This review provides evidence that patients undergoing surgery for management of degenerative lumbar spine disease have improved clinical outcomes if pre-operative multifidus muscle quality is higher.
Keywords: Low back pain · Degenerative lumbar disease · Multifidus morphology · Spinal surgery · Magnetic resonance imaging
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