Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model.
<h4>Background</h4>In patients with degenerative cervical myelopathy (DCM) that have spinal cord compression and sensorimotor deficits, surgical decompression is often performed. However, there is heterogeneity in clinical presentation and post-surgical functional recovery.<h4>Obje...
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2021
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oai:doaj.org-article:609e1b3cffea4a199baf7220e83306e32021-12-02T20:09:57ZFatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model.1932-620310.1371/journal.pone.0253863https://doaj.org/article/609e1b3cffea4a199baf7220e83306e32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253863https://doaj.org/toc/1932-6203<h4>Background</h4>In patients with degenerative cervical myelopathy (DCM) that have spinal cord compression and sensorimotor deficits, surgical decompression is often performed. However, there is heterogeneity in clinical presentation and post-surgical functional recovery.<h4>Objectives</h4>Primary: a) to assess differences in muscle fat infiltration (MFI) in patients with DCM versus controls, b) to assess association between MFI and clinical disability. Secondary: to assess association between MFI pre-surgery and post-surgical functional recovery.<h4>Study design</h4>Cross-sectional case control study.<h4>Methods</h4>Eighteen patients with DCM (58.6 ± 14.2 years, 10 M/8F) and 25 controls (52.6 ± 11.8 years, 13M/12 F) underwent 3D Dixon fat-water imaging. A convolutional neural network (CNN) was used to segment cervical muscles (MFSS- multifidus and semispinalis cervicis, LC- longus capitis/colli) and quantify MFI. Modified Japanese Orthopedic Association (mJOA) and Nurick were collected.<h4>Results</h4>Patients with DCM had significantly higher MFI in MFSS (20.63 ± 5.43 vs 17.04 ± 5.24, p = 0.043) and LC (18.74 ± 6.7 vs 13.66 ± 4.91, p = 0.021) than controls. Patients with increased MFI in LC and MFSS had higher disability (LC: Nurick (Spearman's ρ = 0.436, p = 0.003) and mJOA (ρ = -0.399, p = 0.008)). Increased MFI in LC pre-surgery was associated with post-surgical improvement in Nurick (ρ = -0.664, p = 0.026) and mJOA (ρ = -0.603, p = 0.049).<h4>Conclusion</h4>In DCM, increased muscle adiposity is significantly associated with sensorimotor deficits, clinical disability, and functional recovery after surgery. Accurate and time efficient evaluation of fat infiltration in cervical muscles may be conducted through implementation of CNN models.Monica PaliwalKenneth A WeberAndrew C SmithJames M ElliottFauziyya MuhammadNader S DahdalehJerzy BodurkaYasin DhaherTodd B ParrishSean MackeyZachary A SmithPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253863 (2021) |
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Medicine R Science Q Monica Paliwal Kenneth A Weber Andrew C Smith James M Elliott Fauziyya Muhammad Nader S Dahdaleh Jerzy Bodurka Yasin Dhaher Todd B Parrish Sean Mackey Zachary A Smith Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| description |
<h4>Background</h4>In patients with degenerative cervical myelopathy (DCM) that have spinal cord compression and sensorimotor deficits, surgical decompression is often performed. However, there is heterogeneity in clinical presentation and post-surgical functional recovery.<h4>Objectives</h4>Primary: a) to assess differences in muscle fat infiltration (MFI) in patients with DCM versus controls, b) to assess association between MFI and clinical disability. Secondary: to assess association between MFI pre-surgery and post-surgical functional recovery.<h4>Study design</h4>Cross-sectional case control study.<h4>Methods</h4>Eighteen patients with DCM (58.6 ± 14.2 years, 10 M/8F) and 25 controls (52.6 ± 11.8 years, 13M/12 F) underwent 3D Dixon fat-water imaging. A convolutional neural network (CNN) was used to segment cervical muscles (MFSS- multifidus and semispinalis cervicis, LC- longus capitis/colli) and quantify MFI. Modified Japanese Orthopedic Association (mJOA) and Nurick were collected.<h4>Results</h4>Patients with DCM had significantly higher MFI in MFSS (20.63 ± 5.43 vs 17.04 ± 5.24, p = 0.043) and LC (18.74 ± 6.7 vs 13.66 ± 4.91, p = 0.021) than controls. Patients with increased MFI in LC and MFSS had higher disability (LC: Nurick (Spearman's ρ = 0.436, p = 0.003) and mJOA (ρ = -0.399, p = 0.008)). Increased MFI in LC pre-surgery was associated with post-surgical improvement in Nurick (ρ = -0.664, p = 0.026) and mJOA (ρ = -0.603, p = 0.049).<h4>Conclusion</h4>In DCM, increased muscle adiposity is significantly associated with sensorimotor deficits, clinical disability, and functional recovery after surgery. Accurate and time efficient evaluation of fat infiltration in cervical muscles may be conducted through implementation of CNN models. |
| format |
article |
| author |
Monica Paliwal Kenneth A Weber Andrew C Smith James M Elliott Fauziyya Muhammad Nader S Dahdaleh Jerzy Bodurka Yasin Dhaher Todd B Parrish Sean Mackey Zachary A Smith |
| author_facet |
Monica Paliwal Kenneth A Weber Andrew C Smith James M Elliott Fauziyya Muhammad Nader S Dahdaleh Jerzy Bodurka Yasin Dhaher Todd B Parrish Sean Mackey Zachary A Smith |
| author_sort |
Monica Paliwal |
| title |
Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| title_short |
Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| title_full |
Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| title_fullStr |
Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| title_full_unstemmed |
Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| title_sort |
fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/609e1b3cffea4a199baf7220e83306e3 |
| work_keys_str_mv |
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