• Sohrab Virk, Joshua Wright-Chisem, Milan Sandhu, Avani Vaishnav, Todd J Albert, Catherine Himo Gang, and Sheeraz Qureshi.
• Hospital for Special Surgery, New York, NY.
• Spine. 2021 Feb 15; 46 (4): 259267259-267.

Study DesignRetrospective cross-sectional cohort.ObjectiveThe aim of this sudy was to determine whether muscle health measurements are associated with health-related quality of life scores (HRQOLs) for patients with lumbar spine pathology.Summary Of Background DataPoor muscle health has been implicated as a source of pain/dysfunction for patients with lumbar spine pathology. Our aim was to quantify the relationship using muscle health measurements and HRQOLs.MethodsThree hundred and eight patients were included (mean age 57.7 ± standard deviation 18.2 years' old). We randomly selected patients into a derivation cohort (200) and validation cohort (108) to create our muscle health grade. We measured muscle health by the lumbar indentation value (LIV), goutallier classification (GC), and ratio of paralumbar muscle cross-sectional area over body mass index (PL-CSA/BMI). A muscle health grade was derived based on whether a measurement showed a statistically significant impact on visual analog scale back and leg pain (VAS-leg and VAS-leg), Oswestry Disability Index (ODI), short-form 12 physical health score (SF-12 PHS), short-form 12 mental health score (SF-12 MHS) and Patient-reported Outcomes Measurement Information System (PROMIS). A variety of statistical tools were used to determine whether there was a relationship between a measurement and HRQOLs.ResultsIn the derivation cohort, a muscle health grade was created based on the GC and PL-CSA/BMI ratio. For patients with a GC ≤2, one point was given. For patients with a PL-CSA/BMI ≥130, one point was given. Patients with 2 points were graded as "A" and 0 or 1 point were graded "B." Within the validation cohort of patients, there was a statistically significant higher PROMIS (mean 34.5 ± standard deviation 12.6 vs. 27.6 ± 14.0, P = 0.002), ODI (38.8 ± 18.3 vs. 45.8 ± 18.1, P = 0.05) and SF-12 PHS (34.7 ± 11.3 vs. 29.1 ± 6.3, P = 0.002) for patients with a good muscle health grade of "A."ConclusionThis study offers an objective measurement of muscle health that correlates with HRQOLs for patients with lumbar spine pathology.Level of Evidence: 3.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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