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Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The physiological state of muscles, tendons, ligaments and fascia impacts function and movement ability. A restricted psoas muscle might limit hip extension, pulling the spine into an arch and placing stress on the hip and lower back, for example. But trainers should always ask ‘why are muscles or fascia tight or weak?’
The locomotor system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
The spine is the commonest site of infection (tuberculous spondylitis, Pott's disease), usually the lower thoracic and lumbar vertebrae (Figure 13.15). Initially one vertebral body is affected with the early involvement of the intervertebral disc. Bone destruction leads to vertebral collapse. A local paraspinal abscess develops and infection may extend along the anterior spinal ligaments to other vertebrae, or track anteriorly along tissue planes. In the lumbar spine infection may spread along the sheath of the psoas muscle to point in the groin as a ‘cold’ or ‘psoas’ abscess. Angulation of the spine may occur with a severe kyphosis (tuberculous gibbus). Patients with vertebral TB may develop spinal cord compression. This may occur early in the disease due to pressure from an extradural abscess or bone or disc material, or late when the cord may be stretched over the apex of a severe kyphosis.
Flat back deformity revision surgery
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Jefferson Wilson, Matthew S. Galetta, Srinivas Prasad
Injury to the lumbosacral plexus and its branches may occur during lateral approaches to the lumbar spine. Care should be taken in retracting and dilating the psoas muscle to protect these neural structures. In particular, care should be taken to restrict retractor opening to the minimal amount needed for exposure and graft placement. The femoral nerve should be retracted from anterior to posterior, and care should be taken that positioning of the patient does not put the femoral nerve under tension, reducing its ability to withstand intraoperative retraction. Finally, the duration of trans-psoas retraction should be minimized.
Body Composition Impacts Hematopoietic Stem Cell Transplant Outcomes in Both Autologous and Allogeneic Transplants: A Systematic Review
Published in Nutrition and Cancer, 2022
One study of 121 auto HSCT recipients with lymphoma evaluated psoas muscle measurements against HSCT outcomes (38). The psoas muscle is a large muscle along the lower lumbar region of the spine that extends to the femur through the pelvis; this muscle aids movements such as walking (40). Per multivariate analysis, psoas indices were not significantly associated with non-relapse mortality after controlling for age, sex, BMI and other related factors; however, when separate analyses were completed for men and women, sarcopenia was associated with non-relapse mortality among men only. Among these men, a decrease of 100 units in total psoas index was associated with an increased hazard of non-relapse mortality (HR 2.37; 95% CI 1.01-5.58, P = 0.048) after controlling for age, BMI, Karnofsky Performance Status (KPS) and Hematopoietic Stem Cell Comorbidity Index (HCT-CI). Authors did note however, the possibility of a lack of power for the lack of statistically significant non-relapse mortality results in women (38).
The assessment of sarcopenia using psoas muscle thickness per height is not predictive of post-operative complications in IBD
Published in Scandinavian Journal of Gastroenterology, 2021
Omeed Alipour, Vivian Lee, Tapas K. Tejura, Melissa Lee Wilson, Zoe Memel, Jaehoon Cho, Kyle Cologne, Caroline Hwang, Ling Shao
Sarcopenia quantification was completed using the validated method described by Gu et al. in cirrhotic patients [3]. To date, there are no previously published cut offs for sarcopenia defined by PMTH in IBD patients. Sarcopenia was defined by sex-specific PMTH at the level of the umbilicus using a 50th percentile median cut off (17.8 mm/m in males, 14.8 mm/m in females). In order to obtain PMTH, the axial and transverse thickness at the level of the umbilicus was obtained on cross-sectional imaging (Figure S1). Psoas muscle thickness was determined as the largest diameter perpendicular to the longest diameter of the psoas muscle. Psoas muscle thickness was normalized to patient stature by dividing the right psoas muscle thickness by the patient’s height (cm). Psoas muscle measurements were performed by a single senior radiologist (T.T.).
Low Psoas-Muscle index is associated with decreased survival in hepatocellular carcinoma treated with transarterial chemoembolization
Published in Annals of Medicine, 2022
Jin-Xing Zhang, Hai-Tao Yan, Ye Ding, Jin Liu, Sheng Liu, Qing-Quan Zu, Hai-Bin Shi
We propose that PMI can serve as a surrogate for the assessment of sarcopenia. The psoas muscle is the main flexor of the hip and also provides postural support of the lumbar spine, sacroiliac, and hip joints. Although it only accounts for approximately 10% of total skeletal muscle area at L3, the psoas is a key muscle for posture and core strength [22] and may more reliably reflect sarcopenia better than other individual muscle groups [23]. In addition, measuring psoas muscle may avoid the confounding effects while ascites accompanied [24].