Student University of South Florida Morsani College of Medicine Tampa, FL, US
Disclosure(s):
Molly Monsour, BS: No financial relationships to disclose
Introduction: Recent studies have examined the role of muscular integrity, particularly central sarcopenia involving the psoas muscles, in lumbar fusion outcomes. However, in longer constructs typical of adult spinal deformity (ASD) surgeries, the reliability of psoas muscle support spanning L1-L5 may be limited. We aimed to assess whether erector spinae (ES) and multifidus (M) muscle integrity affects the risk of hardware failure (HF) in ASD patients.
Methods: A retrospective review spanned 2016-2023, encompassing ASD cases at our tertiary care center. We utilized the Goutallier classification system (GCS) to grade ES at the upper instrumented level and L4-L5, assessing intramuscular fat via MRI. Patients with prior laminectomy or existing hardware at assessed levels were excluded from statistical analyses. HF included pseudoarthrosis, rod pull-out, rod fracture, or screw fracture, analyzed using SPSS.
Results: Data from 265 patients (mean age 64.2 years, 56% male) revealed HF in 99 patients (37%). Specific HF types included screw pullout (4%), screw fracture (3%), rod fracture (21%), rod pullout (1%), and pseudoarthrosis (28%). Mann-Whitney tests and Spearman Rho correlations indicated no significant associations between sarcopenia (GCS scores) and HF.
Conclusion : While muscle quality may aid in post-operative recovery, our findings suggest that ES and M muscle qualities do not predict hardware failure in ASD surgeries. This underscores the complex interplay of muscular support and hardware integrity in these surgical outcomes.
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