Scholarlink

Purpose <p>To evaluate whether preoperative fat infiltration (FI) in paraspinal muscles (PSM), specifically the multifidus (MF) and erector spinae (ES), is a reliable predictor of adjacent segment disease (ASD) after lumbar spinal fusion in adults. </p> Methods <p>A systematic review and meta-analysis was conducted by searching PubMed, Embase, and Scopus from inception to March 2025. Studies with cohort or case–control designs reporting on preoperative FI and ASD development were included. Of 630 studies, 11 met the eligibility criteria, involving 1,474 patients, and were analyzed. Mean differences were pooled using a random-effects model. </p> Results <p>Pooled analysis showed that preoperative FI was significantly higher in the ASD development group (MD = 4.83%; 95% CI: 3.28 to 6.39; I² = 59.0%). Patients in the ASD group were significantly older compared to controls (MD = 1.88 years; 95% CI: 0.89 to 2.86). Subgroup analysis by fusion length (short vs. long) and muscle type (MF vs. PSM) revealed no significant differences in effect sizes, indicating the consistent predictive value of FI across groups. Meta-regression analyses indicated that fusion length and patient age did not significantly moderate the association between FI and ASD, suggesting that FI is an independent predictor regardless of these demographic and surgical factors. Conclusion: Preoperative PSM FI is associated with increased ASD risk after LSF. Incorporating FI assessment into preoperative surgical planning may help optimize outcomes, while targeted preoperative muscle optimization could offer a promising strategy to improve long-term results.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Role of paraspinal muscle fatty infiltration in predicting adjacent segment disease after lumbar spinal fusion: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年6月18日

查看全文
  • Tan Lam Minh Nguyen,
  • Hsuan-Tung Lee,
  • Yu-Chi Hsu,
  • Tan Thanh Nguyen,
  • Duy Nguyen Anh Tran,
  • Serena Hu,
  • Jason Pui-Yin Cheung,
  • Klaus John Schnake,
  • Wongthawat Liawrungrueang,
  • Takaki Yoshimizu,
  • Daisuke Sakai,
  • Jason C Hsu,
  • Hsin-Lun Lee,
  • Sung Huang Laurent Tsai,
  • Khanh Nguyen Quoc Le,
  • Meng-Huang Wu

摘要

Purpose

To evaluate whether preoperative fat infiltration (FI) in paraspinal muscles (PSM), specifically the multifidus (MF) and erector spinae (ES), is a reliable predictor of adjacent segment disease (ASD) after lumbar spinal fusion in adults.

Methods

A systematic review and meta-analysis was conducted by searching PubMed, Embase, and Scopus from inception to March 2025. Studies with cohort or case–control designs reporting on preoperative FI and ASD development were included. Of 630 studies, 11 met the eligibility criteria, involving 1,474 patients, and were analyzed. Mean differences were pooled using a random-effects model.

Results

Pooled analysis showed that preoperative FI was significantly higher in the ASD development group (MD = 4.83%; 95% CI: 3.28 to 6.39; I² = 59.0%). Patients in the ASD group were significantly older compared to controls (MD = 1.88 years; 95% CI: 0.89 to 2.86). Subgroup analysis by fusion length (short vs. long) and muscle type (MF vs. PSM) revealed no significant differences in effect sizes, indicating the consistent predictive value of FI across groups. Meta-regression analyses indicated that fusion length and patient age did not significantly moderate the association between FI and ASD, suggesting that FI is an independent predictor regardless of these demographic and surgical factors. Conclusion: Preoperative PSM FI is associated with increased ASD risk after LSF. Incorporating FI assessment into preoperative surgical planning may help optimize outcomes, while targeted preoperative muscle optimization could offer a promising strategy to improve long-term results.