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European Spine Journal
Published in: European Spine Journal 1/2017

01-01-2017 | Original Article

Effect of pure muscle retraction on multifidus injury and atrophy after posterior lumbar spine surgery with 24 weeks observation in a rabbit model

Authors: Zhi-Jun Hu, Jian-Feng Zhang, Wen-Bin Xu, Feng-Dong Zhao, Ji-Ying Wang, Shun-Wu Fan, Xiang-Qian Fang

Published in: European Spine Journal | Issue 1/2017

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Abstract

Purpose

To evaluate the effect of pure muscle retraction on multifidus injury and atrophy.

Materials and methods

Sixty-three adult New Zealand white rabbits were divided evenly into three groups: 1-h retraction (group R1), 2-h retraction (R2), and sham surgery (C). The multifidus muscle was evaluated using magnetic resonance imaging (MRI) and histology after 3 and 48 h, and 1, 3, 6, 12, and 24 weeks after surgery.

Results

Multifidus muscle injury and atrophy were not observed in group C, but were obvious in groups R1 and R2. Edema, necrosis, and inflammation mainly occurred in the first week postoperatively, and were more severe in R2 than in R1 (P < 0.01). Muscle fiber regeneration began at week 1, fibrotic changes mainly occurred at weeks 3 and 6, and fat degeneration became obvious at weeks 12 and 24 postoperatively. The fibrosis and fat degeneration scores of R2 were higher than those of R1 (P < 0.01). Decreased acetylcholine activity and granular degeneration of the neuromuscular junction were observed in both retraction groups, but was more severe in R2 than in R1 (P < 0.01).

Conclusion

Muscle retraction was an important factor not only for multifidus injury, but also for long-term multifidus atrophy after posterior lumbar surgery; a longer retraction time caused more severe multifidus injury and atrophy. Muscle fibers can be regenerated postoperatively, and denervation might be the reason for muscle atrophy.
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Metadata
Title
Effect of pure muscle retraction on multifidus injury and atrophy after posterior lumbar spine surgery with 24 weeks observation in a rabbit model
Authors
Zhi-Jun Hu
Jian-Feng Zhang
Wen-Bin Xu
Feng-Dong Zhao
Ji-Ying Wang
Shun-Wu Fan
Xiang-Qian Fang
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 1/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4247-9

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