DC FieldValueLanguage
dc.contributorDepartment of Rehabilitation Sciencesen_US
dc.creatorWong, AYLen_US
dc.creatorHarada, Gen_US
dc.creatorLee, Ren_US
dc.creatorGandhi, SDen_US
dc.creatorDziedzic, Aen_US
dc.creatorEspinozaOrias, Aen_US
dc.creatorParnianpour, Men_US
dc.creatorLouie, PKen_US
dc.creatorBasques, Ben_US
dc.creatorAn, HSen_US
dc.creatorSamartzis, Den_US
dc.date.accessioned2021-05-13T08:32:43Z-
dc.date.available2021-05-13T08:32:43Z-
dc.identifier.issn0736-0266en_US
dc.identifier.urihttp://hdl.handle.net/10397/89923-
dc.language.isoenen_US
dc.publisherJohn Wiley & Sonsen_US
dc.subjectAdjacent segmenten_US
dc.subjectCervicalen_US
dc.subjectDegenerationen_US
dc.subjectDiscen_US
dc.subjectDiseaseen_US
dc.subjectMusclesen_US
dc.subjectParaspinalen_US
dc.subjectSpineen_US
dc.titlePreoperative paraspinal neck muscle characteristics predict early onset adjacent segment degeneration in anterior cervical fusion patients : a machine-learning modeling analysisen_US
dc.typeJournal/Magazine Articleen_US
dc.identifier.spage1732en_US
dc.identifier.epage1744en_US
dc.identifier.volume39en_US
dc.identifier.issue8en_US
dc.identifier.doi10.1002/jor.24829en_US
dcterms.abstractEarly onset adjacent segment degeneration (ASD) can be found within six months after anterior cervical discectomy and fusion (ACDF). Deficits in deep paraspinal neck muscles may be related to early onset ASD. This study aimed to determine whether the morphometry of preoperative deep neck muscles (multifidus and semispinalis cervicis) predicted early onset ASD in patients with ACDF. Thirty-two cases of early onset ASD after a two-level ACDF and 30 matched non-ASD cases were identified from a large-scale cohort. The preoperative total cross-sectional area (CSA) of bilateral deep neck muscles and the lean muscle CSAs from C3 to C7 levels were measured manually on T2-weighted magnetic resonance imaging. Paraspinal muscle CSA asymmetry at each level was calculated. A support vector machine (SVM) algorithm was used to identify demographic, radiographic, and/or muscle parameters that predicted proximal/distal ASD development. No significant between-group differences in demographic or preoperative radiographic data were noted (mean age: 52.4 ± 10.9 years). ACDFs comprised C3 to C5 (n = 9), C4 to C6 (n = 20), and C5 to C7 (n = 32) cases. Eighteen, eight, and six patients had proximal, distal, or both ASD, respectively. The SVM model achieved high accuracy (96.7%) and an area under the curve (AUC = 0.97) for predicting early onset ASD. Asymmetry of fat at C5 (coefficient: 0.06), and standardized measures of C7 lean (coefficient: 0.05) and total CSA measures (coefficient: 0.05) were the strongest predictors of early onset ASD. This is the first study to show that preoperative deep neck muscle CSA, composition, and asymmetry at C5 to C7 independently predicted postoperative early onset ASD in patients with ACDF. Paraspinal muscle assessments are recommended to identify high-risk patients for personalized intervention.en_US
dcterms.bibliographicCitationJournal of orthopaedic research, Aug. 2021, v. 39, no. 8, p. 1732-1744en_US
dcterms.isPartOfJournal of orthopaedic researchen_US
dcterms.issued2021-08-
dc.identifier.scopus2-s2.0-85089922141-
dc.identifier.pmid32816312-
dc.identifier.eissn1554-527Xen_US
dc.description.validate202105 bcvcen_US
dc.description.oaNot applicableen_US
dc.identifier.FolderNumbera0829-n15-
dc.identifier.SubFormID1905-
dc.description.fundingSourceSelf-fundeden_US
dc.description.pubStatusEarly releaseen_US
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