Characteristics of the psoas minor muscle in modeling lateral interbody spondylodesis of the lumbar spine

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Abstract

ВACKGROUND: For the treatment of degenerative diseases of the spine, various deformities, a minimally invasive technique of lateral lumbar interbody fusion is used, which minimizes the risks of spinal cord injury. In the development of these pathologies, the most important role is assigned to the paraspinal muscles, the histological features of which are insufficiently elucidated in the relevant literature when modeling spondylodesis.

АIM: To investigate the effect of lateral interbody vertebral fusion (spondylodesis) when introducing titanium implants on the histostructure of the psoas minor muscle.

МATERIALS AND METHODS: Experiments were performed in 14 mongrel dogs, 3 individuals — the control group (norm). The аnimals underwent discectomy at the level of L4–5, L5–6 vertebrae through the lateral approach on the right, and interbody titanium implants were installed. The lumbar spine was stabilized with an external fixator for 30 days. Paraffin muscle sections were stained with hematoxylin-eosin, according to Masson.

RESULTS: During the experiment, an increased variety of myosymplast diameters, loss of polygonality of their profiles, fibrosis of the interstitial space, and sclerotization of the vascular membranes were observed in the psoas minor muscle. The volume density of endomysium in both muscles increased 1.5 times relative to the norm after 6 months Other parameters decreased: the volume of myosymplasts was 95%, that of microvessels — 73% on the left, 83% on the right. On the other hand, the degree of fatty infiltration increased, amounting to 276% on the left and 394% — on the right of the normal parameters. After 18 months, the bulk density of muscle fibers on the left was restored to the value in the control, on the right it was only 95%. The degree of sclerotization in the muscle on the left is 133%, on the right — 161% of the norm; the index of fatty infiltration was 146% on the left and 339% on the right of the normal parameter.

CONCLUSION: pathohistological changes in the psoas minor during lateral interbody fusion are more pronounced on the side of the operative approach, which necessitates minimizing trauma to the paravertebral muscles during operations in order to prevent sclerotization and fatty involution of muscle tissue.

About the authors

Galina N. Filimonova

Russian Ilisarov Medical Research Center for Traumatology and Orthopedics

Author for correspondence.
Email: galnik.kurgan@yandex.ru
ORCID iD: 0000-0002-8929-8784
SPIN-code: 3007-1309
Scopus Author ID: 57196004532

Cand. Sci. (Biol.), senior researcher

Russian Federation, Kurgan

Olga V. Diuriagina

Russian Ilisarov Medical Research Center for 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

Russian Ilisarov Medical Research Center for Traumatology and Orthopedics

Email: aniv-niko@mail.ru
ORCID iD: 0000-0002-8627-2749
SPIN-code: 3754-7508
Scopus Author ID: 55207639900

Cand. Sci. (Biol.), researcher

Russian Federation, Kurgan

Sergei O. Ryabykh

N.N. Priorov Russian Scientific Research Institute of Traumatology and Orthopedics

Email: ryabykhco@cito-priorov.ru
ORCID iD: 0000-0002-8293-0521
SPIN-code: 6382-1107
Scopus Author ID: 54941390600

MD, Dr. Sci. (Med.), traumatologist-ortopedist, pediatric and spinal surgeon

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Operating field. View of the implant after insertion into the interbody space.

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3. Fig. 2. The appearance of the ventral surface of the canine lumbar region six months after surgery. Right — m. psoas minor on the right, Left — the muscle on the left; L4–5, L5–6 — level of interbody implant placement.

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4. Fig. 3. Histostructure of m. psoas minor in control: a — polygonal profiles of fibers, minimum endomysium; b — nerve trunk without pathology. Fragments of paraffin sections, stained with hematoxylin-eosin, magnification: а — ×400; b — ×200.

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5. Fig. 4. Histostructure of m. psoas minor after six months of the experiment on the left (a) and on the right (b): a — various profiles and diameters of myosymplasts; b — a vessel of the arterial unit link with signs of adventitial fibrosis and thickened t. media, smooth muscle cells are disoriented. The fragments of paraffin sections, stained with hematoxylin-eosin, magnification — ×400.

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6. Fig. 5. Histostructure of m. psoas minor after 12 (a, b), 18 (c–e) months of the experiment to the left (a, c) and to the right (b, d, e) of the spine: a, b — polygonal profiles of muscle fibers, normostructure of vessels and neuromuscular spindles, accumulations of adipocytes in the perimysial space; c — fibrosis of the endomysium, single adipocytes in bundles of myosymplasts, in the enlarged perimysium of accumulations of fat cells; d — fragment of muscle tissue fibrosis with myocytes of various profiles; e — spasmodic vessels are immersed in accumulations of adipocytes that have replaced muscle fibers. Fragments of paraffin sections, stained with hematoxylin-eosin, magnification: ×400; c — ×200.

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