Elliott James, Jull Gwendolen, Noteboom Jon Timothy, Galloway Graham
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Man Ther. 2008 Jun;13(3):258-65. doi: 10.1016/j.math.2007.01.012. Epub 2007 Mar 26.
Cervical muscle function is disturbed in patients with persistent pain related to a whiplash associated disorder (WAD) but little is known about neck extensor muscle morphometry in this group. This study used magnetic resonance imaging to measure relative cross-sectional area (rCSA) of the rectus capitis posterior minor and major, multifidus, semispinalis cervicis and capitis, splenius capitis and upper trapezius muscles bilaterally at each cervical segment. In total, 113 female subjects (79 WAD, 34 healthy control; 18-45 years, 3 months-3 years post-injury) were recruited for the study. Significant main effects for differences in muscle and segmental level were found between the two groups (P < 0.0001) as well as a significant group * muscle * level interaction (P < 0.0001). The cervical multifidus muscle in the WAD group had significantly larger rCSA at all spinal levels and in contrast, there were variable differences in rCSA measures across levels in the intermediate and superficial extensor muscles when compared to the healthy controls (P < 0.0001). There were occasional weak, although statistically significant relationships between age, body mass index (BMI), duration of symptoms and the size of some muscles in both healthy control and WAD subjects (P < 0.01). It is possible that the consistent pattern of larger rCSA in multifidus at all levels and the variable pattern of rCSA values in the intermediate and superficial muscles in patients with WAD may reflect morphometric change due to fatty infiltrate in the WAD muscles. Future clinical studies are required to investigate the relationships between muscular morphometry, symptoms and function in patients with persistent WAD.
在患有与挥鞭样损伤相关疾病(WAD)的持续性疼痛患者中,颈部肌肉功能会受到干扰,但对于该群体中颈部伸肌的肌肉形态测量知之甚少。本研究使用磁共振成像来测量头后小直肌、头后大直肌、多裂肌、颈半棘肌、头半棘肌、头夹肌和上斜方肌在每个颈椎节段双侧的相对横截面积(rCSA)。总共招募了113名女性受试者(79名WAD患者,34名健康对照;年龄在18 - 45岁之间,受伤后3个月至3年)参与该研究。两组之间在肌肉和节段水平差异上存在显著的主效应(P < 0.0001),以及显著的组肌肉水平交互作用(P < 0.0001)。WAD组的颈部多裂肌在所有脊柱水平的rCSA均显著更大,相比之下,与健康对照相比,中间层和浅层伸肌的rCSA测量值在不同水平存在差异(P < 0.0001)。在健康对照和WAD受试者中,年龄、体重指数(BMI)、症状持续时间与某些肌肉大小之间偶尔存在微弱但具有统计学意义的关系(P < 0.01)。WAD患者中多裂肌在所有水平rCSA更大的一致模式以及中间层和浅层肌肉rCSA值的可变模式可能反映了WAD肌肉中脂肪浸润导致的形态测量变化。未来需要进行临床研究来调查持续性WAD患者肌肉形态测量、症状和功能之间的关系。
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