[Correlation of Vertebral Bone Quality and Paraspinal Muscle Changes With Adjacent Segment Degeneration After Transforaminal Lumbar Interbody Fusion Operation].

The incidence of postoperative ASD in patients who have undergone TLIF for LDD was found to be associated with higher BMI, preoperative VBQ, and increased postoperative relative fat infiltration of the ES and MF muscles. Consequently, it is advisable to prioritize the intraoperative protection of the paraspinal muscles during TLIF. In the postoperative period, it is essential to strengthen exercises of the lower back muscles and to optimize bone mass and weight management, which is conducive to reducing the risk of ASD in the postoperative period.