Department of Orthopaedic Surgery, Keio University, Japan.
Injury. 2012 Jun;43(6):912-6. doi: 10.1016/j.injury.2012.01.017. Epub 2012 Feb 4.
Long-term follow-up studies focusing on the posterior extensor muscles in patients suffering from whiplash injury are scarce. The purpose of this study was to elucidate the changes in the posterior extensor muscles 10 years after whiplash injury.
Twenty-three patients who had suffered from whiplash injury in 1994-1996 and had undergone MRI using a 1.5-T superconductive imager participated in this follow-up study (13 males, 10 females, mean age 51.8 years, mean follow-up 11.5 years). In addition, 60 healthy volunteers who had undergone MRI in the same period were included as controls (36 males, 24 females, mean age 47.8 years, mean follow-up 11.1 years). All participants underwent follow-up MRI. The cross-sectional areas of the deep posterior muscles (CSA) including the multifidus, semispinalis cervicis, semispinalis capitis, and splenius capitis were digitally measured at C3-4, C4-5, and C5-6 using NIH image. The long-term changes in the CSA were compared between the two groups. In addition, correlations between the CSA and cervical spine-related symptoms were evaluated.
The mean total CSA per patient (the sum of the area from C3-4 to C5-6) was 4811.6±878.4 mm(2) in the whiplash patients and 4494.9±1032.7 mm(2) in the controls at the initial investigation (p=0.20), and 5173.4±946.1 mm(2) and 4713.0±1065.3 mm(2) at the follow-up (p=0.07). The mean change in CSA over time was 361.8±804.9 mm(2) in the whiplash patients and 218.1±520.7 mm(2) in the controls (p=0.34). Ten whiplash patients (43.5%) had neck pain and 11 (47.8%) had shoulder stiffness. However, there was no difference in the change in CSA over time between the symptomatic and asymptomatic patients.
There was no significant difference in the change in CSA between whiplash patients and healthy volunteers after a 10-year follow-up period. In both groups, the cross-sectional area slightly increased at follow-up. In addition, there was no association between the change in CSA and clinical symptoms such as neck and shoulder pain. These results suggest that whiplash injury is not associated with symptomatic atrophy of the posterior cervical muscles over the long term.
针对患有挥鞭伤的患者的后部伸肌的长期随访研究很少。本研究的目的是阐明挥鞭伤 10 年后后部伸肌的变化。
23 名在 1994-1996 年遭受挥鞭伤的患者参加了这项随访研究（13 名男性，10 名女性，平均年龄 51.8 岁，平均随访 11.5 年）。此外，还纳入了在同一时期接受 MRI 的 60 名健康志愿者作为对照组（36 名男性，24 名女性，平均年龄 47.8 岁，平均随访 11.1 年）。所有参与者均接受了随访 MRI。使用 NIH 图像在 C3-4、C4-5 和 C5-6 处对包括多裂肌、颈半棘肌、头半棘肌和头夹肌在内的深部后肌的横截面积（CSA）进行数字测量。比较两组之间 CSA 的长期变化。此外，还评估了 CSA 与颈椎相关症状之间的相关性。
挥鞭伤患者的初始检查时，每位患者的总 CSA（C3-4 至 C5-6 的面积总和）平均为 4811.6±878.4mm(2)，对照组为 4494.9±1032.7mm(2)(p=0.20)，随访时为 5173.4±946.1mm(2)和 4713.0±1065.3mm(2)(p=0.07)。挥鞭伤患者的 CSA 随时间的平均变化为 361.8±804.9mm(2)，对照组为 218.1±520.7mm(2)(p=0.34)。10 名挥鞭伤患者（43.5%）有颈部疼痛，11 名（47.8%）有肩部僵硬。然而，在有症状和无症状患者中，CSA 随时间的变化无差异。
在 10 年的随访期后，挥鞭伤患者与健康志愿者之间的 CSA 变化无显著差异。在两组中，CSA 在随访时均略有增加。此外，CSA 的变化与颈部和肩部疼痛等临床症状之间没有关联。这些结果表明，挥鞭伤与长期无症状的颈后部肌肉萎缩无关。
