Wright J, Herbert M A, Velazquez R, Bobechko W P
Hospital for Sick Children, Toronto, Ontario, Canada.
Spine (Phila Pa 1976). 1992 Jul;17(7):767-70. doi: 10.1097/00007632-199207000-00007.
The purpose of this investigation was to examine the morphologic and histochemical characteristics of paraspinal muscles in patients with scoliosis after long-term electrical stimulation. Thirty-six children with idiopathic scoliosis, who had been treated with implantable muscle stimulators, had paraspinal muscle biopsies at the time of implantable muscle stimulator removal. Group A patients whose curve did not progress, had 2.9 years of stimulation stopped at skeletal maturity, with a further 1.5 years of nonstimulation before implant removal and biopsy. In group B patients, who had an average of 2.3 years of stimulation, the curve progressed and stimulation was continued until fusion and biopsy. Neither group showed any increase in the frequency of pathologic changes of paraspinal muscles contrasted with values reported in the literature for scoliotic muscle. In group A patients there was an increased proportion of type 1 fibers on the convex side of the curve compared to the concavity. Despite this finding the curves did not require fusion, suggesting that the increased percentage of type 1 fibers was not the cause of the scoliosis. In group B patients there was an even higher type 1 concentration on the convex side contrasted to the convex side of group A patients.
本研究的目的是检查长期电刺激后脊柱侧弯患者椎旁肌的形态学和组织化学特征。36例接受植入式肌肉刺激器治疗的特发性脊柱侧弯儿童,在移除植入式肌肉刺激器时进行了椎旁肌活检。A组患者的侧弯未进展,在骨骼成熟时停止刺激2.9年,在移除植入物和活检前又有1.5年未刺激。B组患者平均刺激2.3年,侧弯进展且刺激持续至融合和活检。与文献报道的脊柱侧弯肌肉病理变化频率相比,两组椎旁肌病理变化频率均未增加。A组患者侧弯凸侧的I型纤维比例高于凹侧。尽管有这一发现,但侧弯并不需要融合,这表明I型纤维比例增加不是脊柱侧弯的原因。B组患者凸侧的I型纤维浓度甚至高于A组患者的凸侧。