Fortin M, Gibbons L E, Videman T, Battié M C
Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, University of Washington, Seattle, Washington, USA.
Scand J Med Sci Sports. 2015 Dec;25(6):880-7. doi: 10.1111/sms.12301. Epub 2014 Aug 18.
This longitudinal study aimed to clarify the longstanding controversy over whether variations in paraspinal muscle morphology (e.g., size, composition and asymmetry) are predictors of low back pain (LBP). A sample of 99 Finnish men were included in this population-based longitudinal study. Data were collected through a structured interview, physical examination and magnetic resonance imaging (MRI). Baseline measurements of the lumbar multifidus and erector spinae muscles were obtained from T2-weighted axial images at L3-L4 and L5-S1, and interview data were obtained at baseline, 1- and 15-year follow-ups. Few of the paraspinal muscle parameters investigated were predictors of change in LBP frequency, intensity or sciatica at 1- and 15-year follow-ups in the population-based sample, and findings were not consistent across muscles and spinal levels. However, greater multifidus and erector spinae fatty infiltration at L5-S1 was associated with a higher risk of having continued, frequent, persistent LBP at 1-year follow-up. None of the relationships observed was confounded by body mass index or the amount of physical activity at work or leisure. This longitudinal study provided evidence that variations in paraspinal muscle morphology on MRI have a limited, if not uncertain, role in the short- and long-term predictions of LBP in men.
这项纵向研究旨在澄清长期以来关于脊柱旁肌肉形态变化（如大小、组成和不对称性）是否为腰痛（LBP）预测指标的争议。99名芬兰男性样本纳入了这项基于人群的纵向研究。数据通过结构化访谈、体格检查和磁共振成像（MRI）收集。从L3-L4和L5-S1水平的T2加权轴向图像获取腰椎多裂肌和竖脊肌的基线测量数据，访谈数据在基线、1年和15年随访时获取。在基于人群的样本中，所研究的脊柱旁肌肉参数中很少有能预测1年和15年随访时LBP频率、强度或坐骨神经痛变化的指标，且不同肌肉和脊柱节段的研究结果不一致。然而，L5-S1水平多裂肌和竖脊肌脂肪浸润程度较高与1年随访时持续、频繁、持续性LBP风险较高相关。观察到的所有关系均未受体重指数或工作或休闲时身体活动量的影响。这项纵向研究提供的证据表明，MRI上脊柱旁肌肉形态变化在男性LBP的短期和长期预测中作用有限，甚至不确定。
