Neurosurgery 96:1044–1053, 2025
This study explores whether sarcopenia, measured by psoas morphometrics, predicts early adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF). Results indicate that decreased psoas area and P:VBR are strong predictors of ASD within three years post-surgery, suggesting implications for surgical decision-making and patient counseling.
• Sarcopenia predicts early adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF) surgery, as shown by decreased psoas area and P:VBR ratios.
• A retrospective study of 109 patients found that 22 (20.2%) developed ASD within 3 years post-surgery.
• Sarcopenic patients had significantly higher rates of ASD (83.33%) compared to nonsarcopenic patients (7.69%).
• Older age, diabetes, and preoperative ODI are significant predictors of ASD.
• Sarcopenia is a stronger predictor of ASD than spinopelvic parameters like PT, LL, and PI-LL mismatch.
• Identifying sarcopenic patients can guide surgical decisions and postoperative care to prevent ASD.
• The study suggests using psoas morphometrics as a simple tool to identify patients at risk for ASD.
• Further research is needed to validate findings and explore the role of sarcopenia in other surgical approaches.
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