Wu Wei-Wei, Hu Zhi-Jun, Fan Shun-Wu, Xu Wen-Bin, Fang Xiang-Qian, Zhao Feng-Dong
Zhongguo Gu Shang. 2014 Mar;27(3):207-12.
To identify the affect of chronic low back pain on multifidus muscle atrophy and fatty infiltration.
From March 2010 to August 2013, a retrospective study were carried out in the department of orthopedics of patients with low back pain. Finally 31 cases were selected to this study including 19 males and 12 females with an average age of 36.4 years ranging from 23 to 55 years. The main symptoms of these patients were repeated back pain. Duration was more than 1 year. X-ray, CT, MRI showed no obvious abnormalities. The changes of net cross-sectional area of multifidus and T2 signal ratio of the same patient were measured at different time by MRI. VAS and Oswestry disability scores were recorded in two MRI examination. Correlation between these change of multifidus net area and T2 signal ratio in two times measurement and duration of low back pain, VAS, Oswestry disability scores were analyzed to find the affection of low back pain on paraspinal multifidus muscle.
The net multifidus cross-sectional area in same case by the second follow-up MRI is significantly smaller than that of the first follow-up, T2 signal ratio at second was significantly higher than that of the first (P < 0.05). The net cross sectional area of multifidus muscles reduced rate were positively correlated with VAS scores, duration and of Oswestry disabilitry scores (P < 0.001). The rate of increase in T2 signal ratio was not correlated with VAS scores,duration and the Oswestry disability scores (P > 0.05).
Chronic low back pain is one of the most important reasons of paraspinal multifidus muscle atrophy and fatty. The duration, VAS and Oswestry disability scores of chronic low back pain were positively correlated with the multifidus muscle atrophy.
确定慢性下腰痛对多裂肌萎缩和脂肪浸润的影响。
2010年3月至2013年8月,在骨科对下腰痛患者进行回顾性研究。最终选取31例患者纳入本研究,其中男性19例,女性12例,平均年龄36.4岁,年龄范围为23至55岁。这些患者的主要症状为反复腰痛,病程超过1年。X线、CT、MRI检查均未发现明显异常。通过MRI在不同时间测量同一患者多裂肌的净横截面积变化和T2信号比值。在两次MRI检查时记录视觉模拟评分(VAS)和Oswestry功能障碍评分。分析两次测量中多裂肌净面积和T2信号比值的这些变化与下腰痛病程、VAS评分、Oswestry功能障碍评分之间的相关性,以探讨下腰痛对椎旁多裂肌的影响。
同一病例第二次随访MRI时多裂肌的净横截面积明显小于第一次随访时,第二次的T2信号比值明显高于第一次(P<0.05)。多裂肌净横截面积减少率与VAS评分、病程及Oswestry功能障碍评分呈正相关(P<0.001)。T2信号比值升高率与VAS评分、病程及Oswestry功能障碍评分无相关性(P>0.05)。
慢性下腰痛是椎旁多裂肌萎缩和脂肪化的最重要原因之一。慢性下腰痛的病程、VAS评分和Oswestry功能障碍评分与多裂肌萎缩呈正相关。