Abstract
AB041. The morphological changes of paraspinal muscles in adult brachial plexus injury
Yun-Cong Zheng1,2,3, David Chwei-Chin Chuang4, Hsiang-Kuang Liang1,5
1Department of Biomedical Engineering, National Taiwan University, Taipei;
2School of Medicine, College of Medicine, Chang Gung University, Taoyuan;
3Department of Neurosurgery, Chang Gung Memorial Hospital at Keelung, Keelung;
4Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan;
5Division of Radiation Oncology, National Taiwan University Hospital, Taipei
Correspondence to: Hsiang-Kuang Liang, MD, PhD. Department of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei 10617; Division of Radiation Oncology, National Taiwan University Hospital, Taipei. Email: hkliang@ntu.edu.tw or d11528018@ntu.edu.tw.
Background: Traumatic brachial plexus injury (BPI) is a debilitating injury that has a devastating impact. However, management of BPI remains a complex challenge, not only in diagnosis but also in treatment strategies for reconstructive microsurgeons. The aim of this study was to develop an additional assessment tool for root avulsion based on the volume of paraspinal muscle (PM) prior to surgical intervention, making the preoperative diagnosis more precise.
Methods: This retrospective study was centered on adult patients with BPI who underwent surgical exploration and treatment, postoperative follow-up at the Chang Gung Hospital. Labeling of PMs was aided by semi-automated segmentation using 3D Slicer 5.2.2. Slices spanning from the lower end of the upper vertebral body endplate to the upper end of the lower vertebral body. The ratio of muscle volume on the lesion side to that on the normal side (L/N ratio), indicating the volume proportion between the injured and healthy areas, serves as the primary parameter for assessing the relationship in root avulsion.
Results: The L/N ratio for the deepest layers of PMs consistently predicted the level of root injury across C4 to C7 levels, with all reaching statistical significance. In terms of partial and total root avulsion, the L/N ratio of layer 4th at 0.78 significantly outperforms other methods. Concerning the timing of MRI, both partial avulsion (PA) and total avulsion (TA) groups of merge roots showed a statistically significant decrease in the L/N ratio over time.
Conclusions: In conclusion, the L/N volume ratio of 4th layer in PMs reliably predicts the functional severity of avulsed roots and surpasses the performance of traditional diagnostic tools under specific conditions.
Keywords: Paraspinal muscle (PM); brachial plexus injury (BPI); magnetic resonance imaging (MRI)
Acknowledgments
We would like to thank the support from Chang Gung Memorial Hospital.
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab041/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by the Chang Gung Medical Foundation Institutional Review Board (IRB No. 202100204B0). Because of the retrospective nature of the research, the requirement for informed consent was waived.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
Cite this abstract as: Zheng YC, Chuang DCC, Liang HK. AB041. The morphological changes of paraspinal muscles in adult brachial plexus injury. Chin Clin Oncol 2024;13(Suppl 1):AB041. doi: 10.21037/cco-24-ab041
