Stokes M, Rankin G, Newham D J
Institute of Complex Neuro-disability, Royal Hospital for Neuro-disability, London, UK.
Man Ther. 2005 May;10(2):116-26. doi: 10.1016/j.math.2004.08.013. Epub 2004 Nov 18.
This cross-sectional, prospective study aimed to produce normal reference data for measurements of the lumbar multifidus muscle. A total of 120 subjects, 68 females (aged 20-64 years) and 52 males (20-69 years) were studied. Bilateral transverse ultrasound images were made of multifidus at the fourth and fifth lumbar vertebrae (L4 & L5). Cross-sectional area (CSA, cm(2)) and linear dimensions (AP, anteroposterior; Lat, lateral) were measured and the latter expressed as a ratio (AP/Lat) to reflect shape. Relationships between CSA and anthropometric measures were examined. Multifidus CSA was larger in males (P<0.001) and age had no effect. The CSA was larger at L5 than L4 (P<0.001) and highly correlated between the two levels (males r=0.82, females 0.80). Differences in muscle shape were observed for gender, age and vertebral level. Between-side symmetry was high for size but not shape (CSA <10% difference). Linear measurements multiplied (APxLat) correlated highly with CSA (all groups r0.94, P<0.0001). The AP dimension was also acceptably predictive of CSA at L4 (r0.79). There were no clinically useful correlations between CSA and anthropometric measures. These findings provide normal references ranges for objective assessment of lumbar multifidus. This paper also addresses specific practical issues when scanning multifidus.
这项横断面前瞻性研究旨在生成腰椎多裂肌测量的正常参考数据。共研究了120名受试者，其中68名女性（年龄20 - 64岁）和52名男性（20 - 69岁）。对第四和第五腰椎（L4和L5）水平的双侧多裂肌进行横向超声成像。测量横截面积（CSA，cm²）和线性尺寸（前后径，AP；横径，Lat），后者以比值（AP/Lat）表示以反映形状。检查CSA与人体测量指标之间的关系。男性的多裂肌CSA更大（P<0.001），年龄无影响。L5水平的CSA大于L4（P<0.001），且两个水平之间高度相关（男性r = 0.82，女性0.80）。观察到肌肉形状在性别、年龄和椎体水平上存在差异。两侧大小对称性高，但形状不对称（CSA差异<10%）。线性测量值相乘（AP×Lat）与CSA高度相关（所有组r>0.94，P<0.0001）。AP维度对L4水平的CSA也有较好的预测性（r = 0.79）。CSA与人体测量指标之间没有临床有用的相关性。这些发现为客观评估腰椎多裂肌提供了正常参考范围。本文还讨论了扫描多裂肌时的具体实际问题。
