Multifidus muscle changes after biportal endoscopic spinal surgery (BESS): magnetic resonance image evaluation

2019 
Abstract Object The authors used magnetic resonance image (MRI) to assess the radiological status of multifidus muscle (MF) after biportal endoscopic spinal surgery (BESS) and evaluated the extent of MF injury and atrophy. Methods 88 who met the inclusion and exclusion criteria were enrolled. T2-weighted signal intensity MRI was performed three times: preoperatively, immediately postoperatively, and on final follow-up. We measured the cross-sectional area (CSA) of the MF on both sides (ipsilateral and contralateral) and recorded operative times. On entire patient analysis, the association between the time interval, from surgery to final follow-up MRI and change in MF, and between the operative time and change in MF, were analyzed. For group comparisons, patients were divided into three Groups, I, II, and III, by the time interval. Group I was followed up within 2 weeks, Group II within 2 to 4 weeks, and Group III after 4 weeks. MF changes were recorded. Results The operative time correlated significantly with the percentage change in the T2 signal intensity ratios (SIR) of both sides (p Conclusions MF change after BESS on MRI was significant on both sides as the operative time increased. However, the change tended to reverse within several months, and no substantial change of MF CSA was found. We conclude that MF change after BESS might be correlated with operative time; however, be reversible.
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