Guo Xuchao, Zhang Xu, Ding Wenyuan, Yang Dalong, Ma Lei, Xie Dongxiao, Wang Hui, Wang Haiying, Lu Kuan, Yang Sidong
Department of Spinal Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.
Department of Spinal Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China. Email:
Zhonghua Wai Ke Za Zhi. 2014 Aug;52(8):571-5.
To compare the paravertebral muscle (such as multifidus, erector spinae, psoas muscle) changes between the patients with degenerative lumbar instability and normal person by MRI and to observe the degeneration of paravertebral muscles. To analyze the relationship between paravertebral muscle degeneration and lumbar curvature of degenerative lumbar instability.
Sixty patients with degenerative lumbar instability were retrospectively enrolled from December 2011 to July 2013 as degeneration group, meanwhile 60 health persons with no degenerative lumbar instability were selected as control group. No significant differences were found in the gender, age and body mass index between the two groups. The cross-sectional area(CSA) and percentage of fat infiltration area (FIA) of the paravertebral muscles at the L4-S1 levels were measured using T2-weighted axial MRI and Image J soft ware. And the lumbar curvature(expressed as lumbar lordosis angle) of all the patients in lumbar X-ray were measured in the two groups. The measured data were analyzed with independent samples t-test.
The difference of multifidus cross-sectional area and the percentage of fat infiltration in the patients of degenerative lumbar instability at the L4-L5, L5-S1 level, compared with the control group, was statistically significant (t = 2.768, t = 6.216, P < 0.05). Between the two groups, the percentage of fatty infiltration in erector spinae showed significant differences (t = 5.862, P < 0.05). The cross-sectional area of erector spinae and the degeneration of the psoas muscle between the two groups was not statistically significant. The lumbar lordsis angle in the patients with degenerative lumbar instability was (43.9 ± 15.6)°, which was higher than the (39.3 ± 14.2)° in control group (t = 2.915, P < 0.05).
Compared with the control group, patients with degenerative lumbar instability exists erector spinae and multifidus muscle degeneration, and erector spinae is more obvious. The degeneration among psoas muscle, erector spinae and multifidus muscle are inconsistent, which may be related to the increasing of the lumbar lordosis angle in the patients with degenerative lumbar instability.
通过磁共振成像（MRI）比较退变性腰椎不稳患者与正常人椎旁肌（如多裂肌、竖脊肌、腰大肌）的变化，观察椎旁肌退变情况。分析退变性腰椎不稳患者椎旁肌退变与腰椎曲度的关系。
回顾性纳入2011年12月至2013年7月60例退变性腰椎不稳患者作为退变组，同时选取60例无退变性腰椎不稳的健康人作为对照组。两组在性别、年龄和体重指数方面无显著差异。使用T2加权轴向MRI和Image J软件测量L4-S1水平椎旁肌的横截面积（CSA）和脂肪浸润面积百分比（FIA）。并测量两组患者腰椎X线片上的腰椎曲度（以腰椎前凸角表示）。测量数据采用独立样本t检验进行分析。
退变性腰椎不稳患者在L4-L5、L5-S1水平多裂肌横截面积和脂肪浸润百分比与对照组相比，差异有统计学意义（t = 2.768，t = 6.216，P < 0.05）。两组间竖脊肌脂肪浸润百分比差异有统计学意义（t = 5.862，P < 0.05）。两组间竖脊肌横截面积和腰大肌退变情况无统计学意义。退变性腰椎不稳患者的腰椎前凸角为（43.9 ± 15.6）°，高于对照组的（39.3 ± 14.2）°（t = 2.915，P < 0.05）。
与对照组相比，退变性腰椎不稳患者存在竖脊肌和多裂肌退变，且竖脊肌退变更明显。腰大肌、竖脊肌和多裂肌之间的退变不一致，这可能与退变性腰椎不稳患者腰椎前凸角增加有关。
