Muscle atrophy and/or muscle weakness after lumbar surgery

Abstract

Methods​: The search strategy applied in PubMed and WOS databases yielded 17 relevant articles after full-text screening. After completing the quality assessment (PEDro-scale and Downs and Black-checklist), a total of 15 articles (evaluating 1106 patients with a mean age of 40 to 64 years old) were analyzed in this literature review. Only Dutch and English studies who investigated the presence of muscle atrophy and/or weakness after lumbar surgery were included. Results​: The results demonstrate that the conventional open (CO) and posterior approaches in lumbar surgery results in a more obvious negative percentages of the mean change muscle size (e.g. muscle volume, CSA) and lower muscle atrophy rates. Early postoperative recovery of muscle strength was only possible after lumbar discectomy, in contrast to lumbar fusion where postoperative recovery lasts longer. Discussion and conclusion: ​Muscle atrophy is present after lumbar surgery, especially regarding to an open or posterior approach, but a future review must consider the effects of operation time and blood loss during surgery. Paraspinal muscles are vulnerable to denervation and atrophy due to the surgical techniques, which may cause muscle weakness. Also, further research is needed to determine the effects of postoperative rehabilitation. Aim of the study: ​ The primary purpose of this review is to measure the degree of muscle atrophy and/or weakness after lumbar decompression, fusion and discectomy.