title: Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion: 10-year follow-up study using MRI.
abstract: OBJECTIVE
  To evaluate changes in the transverse area of deep posterior muscles of the cervical spine 10 years after anterior cervical decompression and fusion (ACDF), in comparison with healthy volunteers.
  
  
  METHODS
  Thirty-one patients (22 males, 9 females, mean age at follow-up 59.3 years, mean follow-up 12.1 years) who had undergone preoperative MRI and non-instrumented ACDF within levels C3-4 to C5-6 were enrolled. 32 asymptomatic volunteers (17 males, 15 females; mean age, 54.7 years; mean follow-up, 11.7 years) who underwent MRI between 1993 and 1996 served as controls. Follow-up MRI was performed on both patients and control subjects, and the cross-sectional areas of deep posterior muscles were measured digitally at levels C3-4, 4-5, and 5-6.
  
  
  RESULTS
  The mean total cross-sectional area in the ACDF and control groups was 4,693.6 ± 1,140.9 and 4,825.8 ± 1,048.2 mm(2) in the first MR study (P = 0.63), and 4,616.7 ± 1,086.0 and 5,036.7 ± 1,105.6 mm(2) at follow-up (P = 0.13). The total cross-sectional area in the ACDF group slightly decreased, while that in the control group increased (-77.1 ± 889.7 vs. 210.9 ± 622.0 mm(2), P = 0.14). The mean change in the cross-sectional area had no significant correlation with clinical symptoms, including neck pain or JOA score.
  
  
  CONCLUSIONS
  ACDF patients did not show a marked decrease in the cross-sectional area of the deep posterior cervical muscles, but as compared with control subjects there was a slight decrease. A decrease in the cross-sectional area of these muscles after ACDF may not result in the axial symptoms as seen in patients treated by posterior surgery.
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo, #160-8582, Japan. morio@sc.itc.keio.ac.jp
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Eijiro
authors.initials: E
authors.lastname: Okada
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichihara
authors.forename: Kota
authors.initials: K
authors.lastname: Watanabe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Chiba
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Toyama
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Suketaka
authors.initials: S
authors.lastname: Momoshima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishiwaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Akio
authors.initials: A
authors.lastname: Iwanami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ikegami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takahata
mesh_terms: D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D009133:Muscular Atrophy / Q000209:etiology* / Q000473:pathology; D009929:Organ Size; D013123:Spinal Fusion / Q000009:adverse effects*