Characteristics of m. Psoas minor and m. Sacrocaudalis (coccygeus) dorsalis lateralis in simultaneous modeling of lateral interbodial spinnylodesis and posterior sacro-iliac joint arthodesis

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Abstract

BACKGROUND: Simultaneous surgical interventions on the spine with the use of high-tech instruments and minimally invasive access techniques allow to eliminate several problems all at once, to activate patients at an early date and to reduce the number of complications.

AIM: To evaluate morphological changes to evaluate morphological changes in the m. Psoas minor and m. Sacrocaudalis dorsalis lateralis during simultaneous modeling of lateral interbody fusion and posterior sacroiliac joint arthrodesis

MATERIALS AND METHODS: Experiments were carried out on 14 outbred dogs; 3 animals formed a control group. The animals underwent consecutive lateral interbody fusion of the lumbar spine and posterior arthrodesis of the sacroiliac joint. The lumbar spine and sacroiliac joint were stabilized with external fixation device. Paraffin sections of muscles were stained with hematoxylin-eosin, according to Van Gieson, and Masson. Biochemical analysis of blood serum was performed during the experiment.

RESULTS: The morphological study of the muscles revealed pathohistological features such as an increase in the variety of myosymplast diameters, loss of their profiles polygonality, massive fibers fatty degeneration, endo- and perimysial fibrosis, sclerotization of vessel membranes, obliteration of their lumens. At the end of the experiment, the degree of the small lumbar muscle fibrosis was 161% and of the sacrocaudal dorsal lateral muscle fibrosis was 240% of the control parameters (p < 0.05); the rate of the muscle fatty infiltration was 339 and 310% of the normal value, respectively. The sacroiliac-caudal dorsal lateral muscle underwent more marked changes, especially in the early stages of the experiment. A significant increase in the enzymes activity, skeletal muscle damage markers was detected on the 14th day after surgery.

CONCLUSION: Simultaneous surgical interventions on the spine should minimize mechanical effects on the paravertebral muscles and use techniques to stimulate their function in the postoperative period, which will reduce the processes of fibrogenesis and fat involution as well as provide an overall shorter rehabilitation period for the target patients.

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About the authors

Galina N. Filimonova

Ilizarov National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: galnik.kurgan@yandex.ru
ORCID iD: 0000-0003-0683-9758

Cand. Sci. (Biol.), Senior Research Associate

Russian Federation, Kurgan

Olga V. Diuriagina

Ilizarov National Medical Research Center of Traumatology and Orthopedics

Email: diuriagina@mail.ru
ORCID iD: 0000-0001-9974-2204
SPIN-code: 8301-1475

Cand. Sci. (Vet.), Head of the Experimental Laboratory

Russian Federation, Kurgan

Nikolai I. Antonov

Ilizarov National Medical Research Center of Traumatology and Orthopedics

Email: aniv-niko@mail.ru
SPIN-code: 3754-7508
Scopus Author ID: 55207639900

Cand. Sci. (Biol.), Research Associate

Russian Federation, Kurgan

Maxim V. Stogov

Ilizarov National Medical Research Center of Traumatology and Orthopedics

Email: Stogo_off@list.ru
ORCID iD: 0000-0001-8516-8571
SPIN-code: 9345-8300

Dr. Sci. (Biol.), Assistant Professor, Head of the Department of Preclinical and Laboratory Research

Russian Federation, Kurgan

Sergei O. Ryabykh

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: RyabykhSO@cito-priorov.ru
ORCID iD: 0000-0002-8293-0521
SPIN-code: 6382-1107

MD, Dr. Sci. (Med.), Deputy Director for Projects, Education and Communication

Russian Federation, Moscow

Natalia V. Tushina

Ilizarov National Medical Research Center of Traumatology and Orthopedics

Email: ntushina76@mail.ru
ORCID iD: 0000-0002-1322-608X
SPIN-code: 7554-9130

Cand. Sci. (Biol.), Research Associate

Russian Federation, Kurgan

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Supplementary files

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2. Fig 1. Surgical field: а — titanium cage between the sacrum and the wings of the ilium of the lumbar vertebrae; b — the position of the cages in the sacroiliac joints (sacrum).

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3. Fig. 2. Histostructure of m. psoas minor (а) and m. sacrocaudalis (coccygeus) dorsalis lateralis (b) in control: polygonal fiber profiles, minimum endomysium; а — neuromuscular spindle; (b) vessel in perimysium without signs of pathology. Fragments of paraffin sections, stained with hematoxylin-eosin; magnification ×400.

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4. Fig. 3. Histostructure of the psoas minor (a, b) and the sacro-caudal (coccygeal) dorsal lateral muscle (c) after 6 months of the experiment: a, c — variability in the size of myosymplasts, endomysial fibrosis, adipocytes in bundles of muscle fibers; b — arterial vessel with severe fibrosis of the adventitial and middle membranes, impaired circular orientation of the smooth muscle cells, obliteration of the lumen. Fragments of paraffin sections; hematoxylin-eosin stain; magnification ×400.

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5. Fig. 4. Histostructure of m. psoas minor (а) and m. sacrocaudalis (coccygeus) dorsalis lateralis (b, c) after 12 months of the experiment: а — polygonal profiles of myosymplasts, minimum endomysium; b — variability in muscle fiber diameters, internal nuclei, an area of significant fibrosis of the interstitial tissue (on the right); c — a bundle of muscle fibers replaced by adipocytes; to the right, an area of fibrosis. Fragments of paraffin sections, stained with hematoxylin-eosin, magnification ×400.

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6. Fig. 5. Histostructure of the psoas minor (a, b) and m. sacrocaudalis dorsalis lateralis (c, d) after 18 months of the experiment: a — myocytes of various profiles and diameters, a group of adipocytes in the muscle bundle (top), a fragment of fibrosis with residual angular muscle fibers (bottom); b — neuromuscular spindles of normal structure and with an enlarged connective tissue capsular; c — polygonal fiber profiles, endomysial fibrosis; d — adipocytes that replaced part of the muscle fibers in the bundle, ischemic fibers are colored blue, fields of adipocytes. Fragments of paraffin sections, stained with hematoxylin-eosin, according to Masson (d); magnification ×400.

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