Department of Orthopaedic Surgery, Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan.
Eur Spine J. 2011 Sep;20(9):1567-73. doi: 10.1007/s00586-011-1774-x. Epub 2011 Mar 23.
There has been no prospective study on age-related changes of the extensor muscles of the cervical spine in healthy subjects. This study was conducted to elucidate any association between the changes in cross-sectional area of the extensor muscles of the cervical spine on MRIs and cervical disc degeneration or the development of clinical symptoms. Sixty-two subjects who underwent MR imaging by a 1.5-Tesla machine between 1993 and 1996 as asymptomatic volunteers in a previous study were recruited again 10 years later for this follow-up study. The mean interval between the studies was 11.0 ± 0.7 years. The cross-sectional areas of the multifidus, semispinalis cervicis, semispinalis capitis, and splenius capitis at C3-C4, C4-C5, and C5-C6 intervertebral levels were measured on T2-weighted axial images using Image J 1.42. The mean cross-sectional areas of the deep extensor muscles were 1,396.8 ± 337.6 mm(2) at the C3-C4 level, 1,514.7 ± 381.0 mm(2) at the C4-C5 level, and 1,542.8 ± 373.5 mm(2) at the C5-C6 level in the previous investigation. The cross-sectional areas were 1,498.7 ± 374.4 mm(2) at the C3-C4 level, 1,569.9 ± 390.9 mm(2) at the C4-C5 level, and 1,599.6 ± 364.3 mm(2) at the 10-year follow-up. An increase in the cross-sectional area of the muscles was more frequently observed in subjects in their tens to thirties in the initial study, while a decrease was more frequently observed in those in their forties and older in the initial study. Disc degeneration was not correlated with a change in extensor muscle volume. Development of shoulder stiffness during follow-up was significantly negatively correlated with a change in the cross-sectional area of the deep extensor muscles.
目前尚未有前瞻性研究探讨健康人群颈椎伸肌随年龄变化的特点。本研究旨在阐明颈椎伸肌 MRI 横截面积的变化与颈椎间盘退变或临床症状的发展之间是否存在关联。62 名受试者曾于 1993 年至 1996 年间参加过一项无症状志愿者的 1.5T 磁共振成像(MRI)研究,10 年后的随访研究再次招募了他们。两次研究的平均间隔时间为 11.0 ± 0.7 年。在 T2 加权轴位图像上,使用 Image J 1.42 软件测量 C3-C4、C4-C5 和 C5-C6 椎间水平多裂肌、颈半棘肌、头半棘肌和头夹肌的横截面积。在前一次研究中,C3-C4 水平的深部伸肌平均横截面积为 1396.8 ± 337.6mm2,C4-C5 水平为 1514.7 ± 381.0mm2,C5-C6 水平为 1542.8 ± 373.5mm2。10 年随访时,C3-C4 水平的横截面积为 1498.7 ± 374.4mm2,C4-C5 水平为 1569.9 ± 390.9mm2,C5-C6 水平为 1599.6 ± 364.3mm2。在初始研究中,肌横截面积增加更多见于十几岁至三十几岁的受试者,而在初始研究中,四十多岁及以上的受试者肌横截面积减少更多。椎间盘退变与伸肌体积变化无关。随访过程中肩部僵硬的发展与深部伸肌横截面积的变化呈显著负相关。