Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease
<i>Background and Objectives</i>: The analgesic effectiveness of epidural adhesiolysis may be influenced by morphological changes in the paraspinal muscles, particularly in elderly patients. The objective of this study was to assess whether the cross-sectional area or fatty infiltration...
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MDPI AG
2023-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/6/1118 |
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| author | Misun Kang Shin Hyung Kim Minju Jo Hyun Eom Jung Jungbin Bae Hee Jung Kim |
| author_facet | Misun Kang Shin Hyung Kim Minju Jo Hyun Eom Jung Jungbin Bae Hee Jung Kim |
| author_sort | Misun Kang |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The analgesic effectiveness of epidural adhesiolysis may be influenced by morphological changes in the paraspinal muscles, particularly in elderly patients. The objective of this study was to assess whether the cross-sectional area or fatty infiltration of the paraspinal muscles impacts the treatment outcomes of epidural adhesiolysis. <i>Materials and Methods</i>: The analysis included a total of 183 patients with degenerative lumbar disease who underwent epidural adhesiolysis. Good analgesia was defined as a reduction in pain score of ≥30% at the 6-month follow up. We measured the cross-sectional area and fatty infiltration rate of the paraspinal muscles and divided the study population into age groups (≥65 years and <65 years). Variables were compared between the good and poor analgesia groups. <i>Results</i>: The results revealed that elderly patients experienced poorer analgesic outcomes as the rate of fatty infiltration in the paraspinal muscles increased (<i>p</i> = 0.029), predominantly in female patients. However, there was no correlation between the cross-sectional area and the analgesic outcome in patients younger than or older than 65 years (<i>p</i> = 0.397 and <i>p</i> = 0.349, respectively). Multivariable logistic regression analysis indicated that baseline pain scores < 7 (Odds Ratio (OR) = 4.039, 95% Confidence Interval (CI) = 1.594–10.233, <i>p</i> = 0.003), spondylolisthesis (OR = 4.074, 95% CI = 1.144–14.511, <i>p</i> = 0.030), and ≥ 50% fatty infiltration of the paraspinal muscles (OR = 6.576, 95% CI = 1.300–33.268, <i>p</i> = 0.023) were significantly associated with poor outcomes after adhesiolysis in elderly patients. <i>Conclusions</i>: Fatty degeneration of paraspinal muscles is correlated with inferior analgesic outcomes following epidural adhesiolysis in elderly patients, but not in young and middle-aged patients. The cross-sectional area of the paraspinal muscles is not associated with pain relief after the procedure. |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T02:11:43Z |
| publishDate | 2023-06-01 |
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| spelling | doaj.art-cb853771a1634ebdb0fdde65667b9f812023-11-18T11:31:43ZengMDPI AGMedicina1010-660X1648-91442023-06-01596111810.3390/medicina59061118Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal DiseaseMisun Kang0Shin Hyung Kim1Minju Jo2Hyun Eom Jung3Jungbin Bae4Hee Jung Kim5Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea<i>Background and Objectives</i>: The analgesic effectiveness of epidural adhesiolysis may be influenced by morphological changes in the paraspinal muscles, particularly in elderly patients. The objective of this study was to assess whether the cross-sectional area or fatty infiltration of the paraspinal muscles impacts the treatment outcomes of epidural adhesiolysis. <i>Materials and Methods</i>: The analysis included a total of 183 patients with degenerative lumbar disease who underwent epidural adhesiolysis. Good analgesia was defined as a reduction in pain score of ≥30% at the 6-month follow up. We measured the cross-sectional area and fatty infiltration rate of the paraspinal muscles and divided the study population into age groups (≥65 years and <65 years). Variables were compared between the good and poor analgesia groups. <i>Results</i>: The results revealed that elderly patients experienced poorer analgesic outcomes as the rate of fatty infiltration in the paraspinal muscles increased (<i>p</i> = 0.029), predominantly in female patients. However, there was no correlation between the cross-sectional area and the analgesic outcome in patients younger than or older than 65 years (<i>p</i> = 0.397 and <i>p</i> = 0.349, respectively). Multivariable logistic regression analysis indicated that baseline pain scores < 7 (Odds Ratio (OR) = 4.039, 95% Confidence Interval (CI) = 1.594–10.233, <i>p</i> = 0.003), spondylolisthesis (OR = 4.074, 95% CI = 1.144–14.511, <i>p</i> = 0.030), and ≥ 50% fatty infiltration of the paraspinal muscles (OR = 6.576, 95% CI = 1.300–33.268, <i>p</i> = 0.023) were significantly associated with poor outcomes after adhesiolysis in elderly patients. <i>Conclusions</i>: Fatty degeneration of paraspinal muscles is correlated with inferior analgesic outcomes following epidural adhesiolysis in elderly patients, but not in young and middle-aged patients. The cross-sectional area of the paraspinal muscles is not associated with pain relief after the procedure.https://www.mdpi.com/1648-9144/59/6/1118elderly patientsdegenerationepidural adhesiolysismyosteatosissarcopeniapain management |
| spellingShingle | Misun Kang Shin Hyung Kim Minju Jo Hyun Eom Jung Jungbin Bae Hee Jung Kim Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease Medicina elderly patients degeneration epidural adhesiolysis myosteatosis sarcopenia pain management |
| title | Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease |
| title_full | Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease |
| title_fullStr | Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease |
| title_full_unstemmed | Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease |
| title_short | Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease |
| title_sort | evaluation of paraspinal muscle degeneration on pain relief after percutaneous epidural adhesiolysis in patients with degenerative lumbar spinal disease |
| topic | elderly patients degeneration epidural adhesiolysis myosteatosis sarcopenia pain management |
| url | https://www.mdpi.com/1648-9144/59/6/1118 |
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