An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging
Study Design A retrospective observational study. Purpose Establish a quantifiable and reproducible measure of sarcopenia in patients undergoing lumbar spine surgery based on morphometric measurements from readily available preoperative computed tomography (CT) imaging. Overview of Literature Sarcop...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2020-12-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2019-0319.pdf |
| _version_ | 1818924571781234688 |
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| author | Marko Tomov Mohammed Ali Alvi Mohamed Elminawy Bradford Currier Michael Yaszemski Ahmad Nassr Paul Huddleston Arjun Sebastian Mohamad Bydon Brett Freedman |
| author_facet | Marko Tomov Mohammed Ali Alvi Mohamed Elminawy Bradford Currier Michael Yaszemski Ahmad Nassr Paul Huddleston Arjun Sebastian Mohamad Bydon Brett Freedman |
| author_sort | Marko Tomov |
| collection | DOAJ |
| description | Study Design A retrospective observational study. Purpose Establish a quantifiable and reproducible measure of sarcopenia in patients undergoing lumbar spine surgery based on morphometric measurements from readily available preoperative computed tomography (CT) imaging. Overview of Literature Sarcopenia—the loss of skeletal muscle mass—has been linked with poor outcomes in several surgical disciplines; however, a reliable and quantifiable measure of sarcopenia for future assessment of outcomes in spinal surgery patients has not been established. Methods A cohort of 90 lumbar spine fusion patients were compared with 295 young, healthy patients obtained from a trauma da¬tabase. Cross-sectional vertebral body (VB) area, as well as the areas of the psoas and paravertebral muscles at mid-point of pedicles at L3 and L4 for both cohorts, was measured using axial CT imaging. Total muscle area-to-VB area ratio was calculated along with intraclass correlation coefficients for interobserver and intraobserver reliability. Finally, T-scores were calculated to help identify those patients with considerably diminished muscle-to-VB area ratios. Results Both muscle mass and VB areas were considerably larger in males compared with those in females, and the ratio of these two measures was not enough to account for large differences. Thus, a gender-based comparison was made between spine patients and healthy control patients to establish T-scores that would help identify those patients with sarcopenia. The ratio for paravertebral muscle area-to-VB area at the L4 level was the only measure with good interobserver reliability, whereas the other three of the four ratios were moderate. All measurements had excellent correlations for intraobserver reliability. Conclusions We postulate that a patient with a T-score <−1 for total paravertebral muscle area-to-VB area ratio at the L4 level is the most reliable method of all our measurements that can be used to diagnose a patient undergoing lumbar spine surgery with sarcopenia. |
| first_indexed | 2024-12-20T02:27:27Z |
| format | Article |
| id | doaj.art-f1f2190b3c4c4528af4ec6fda3455794 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-20T02:27:27Z |
| publishDate | 2020-12-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-f1f2190b3c4c4528af4ec6fda34557942022-12-21T19:56:40ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462020-12-0114681482010.31616/asj.2019.03191210An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography ImagingMarko Tomov0Mohammed Ali Alvi1Mohamed Elminawy2Bradford Currier3Michael Yaszemski4Ahmad Nassr5Paul Huddleston6Arjun Sebastian7Mohamad Bydon8Brett Freedman9 Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAStudy Design A retrospective observational study. Purpose Establish a quantifiable and reproducible measure of sarcopenia in patients undergoing lumbar spine surgery based on morphometric measurements from readily available preoperative computed tomography (CT) imaging. Overview of Literature Sarcopenia—the loss of skeletal muscle mass—has been linked with poor outcomes in several surgical disciplines; however, a reliable and quantifiable measure of sarcopenia for future assessment of outcomes in spinal surgery patients has not been established. Methods A cohort of 90 lumbar spine fusion patients were compared with 295 young, healthy patients obtained from a trauma da¬tabase. Cross-sectional vertebral body (VB) area, as well as the areas of the psoas and paravertebral muscles at mid-point of pedicles at L3 and L4 for both cohorts, was measured using axial CT imaging. Total muscle area-to-VB area ratio was calculated along with intraclass correlation coefficients for interobserver and intraobserver reliability. Finally, T-scores were calculated to help identify those patients with considerably diminished muscle-to-VB area ratios. Results Both muscle mass and VB areas were considerably larger in males compared with those in females, and the ratio of these two measures was not enough to account for large differences. Thus, a gender-based comparison was made between spine patients and healthy control patients to establish T-scores that would help identify those patients with sarcopenia. The ratio for paravertebral muscle area-to-VB area at the L4 level was the only measure with good interobserver reliability, whereas the other three of the four ratios were moderate. All measurements had excellent correlations for intraobserver reliability. Conclusions We postulate that a patient with a T-score <−1 for total paravertebral muscle area-to-VB area ratio at the L4 level is the most reliable method of all our measurements that can be used to diagnose a patient undergoing lumbar spine surgery with sarcopenia.http://www.asianspinejournal.org/upload/pdf/asj-2019-0319.pdfsarcopenialumbarspinesurgerycomputed tomography |
| spellingShingle | Marko Tomov Mohammed Ali Alvi Mohamed Elminawy Bradford Currier Michael Yaszemski Ahmad Nassr Paul Huddleston Arjun Sebastian Mohamad Bydon Brett Freedman An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging Asian Spine Journal sarcopenia lumbar spine surgery computed tomography |
| title | An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging |
| title_full | An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging |
| title_fullStr | An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging |
| title_full_unstemmed | An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging |
| title_short | An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging |
| title_sort | objective and reliable method for identifying sarcopenia in lumbar spine surgery patients using morphometric measurements on computed tomography imaging |
| topic | sarcopenia lumbar spine surgery computed tomography |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2019-0319.pdf |
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