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腰痛患者腰椎功能障碍与腰多裂肌脂肪浸润之间的相关性

Correlation between lumbar dysfunction and fat infiltration in lumbar multifidus muscles in patients with low back pain.

作者信息

Hildebrandt Markus, Fankhauser Gabriela, Meichtry André, Luomajoki Hannu

机构信息

Physio Hildebrandt, Sickingerstrasse 4, 3014, Bern, Switzerland.

, Hauptstrasse 26, 3254, Messen, Switzerland.

出版信息

BMC Musculoskelet Disord. 2017 Jan 10;18(1):12. doi: 10.1186/s12891-016-1376-1.

Abstract

BACKGROUND

Lumbar multifidus muscles (LMM) are important for spinal motion and stability. Low back pain (LBP) is often associated with fat infiltration in LMM. An increasing fat infiltration of LMM may lead to lumbar dysfunction. The purpose of this study was to investigate whether there is a correlation between the severity of lumbar dysfunction and the severity of fat infiltration of LMM.

METHODS

In a cross-sectional study, 42 patients with acute or chronic LBP were recruited. Their MRI findings were visually rated and graded using three criteria for fat accumulation in LMM: Grade 0 (0-10%), Grade 1 (10-50%) and Grade 2 (>50%). Lumbar sagittal range of motion, dynamic upright and seated posture control, sagittal movement control, body awareness and self-assessed functional disability were measured to determine the patients' low back dysfunction.

RESULTS

The main result of this study was that increased severity of fat infiltration in the lumbar multifidus muscles correlated significantly with decreased range of motion of lumbar flexion (p = 0.032). No significant correlation was found between the severity of fat infiltration in LMM and impaired movement control, posture control, body awareness or self-assessed functional disability.

CONCLUSION

This is the first study investigating the relationship between the severity of fat infiltration in LMM and the severity of lumbar dysfunction. The results of this study will contribute to the understanding of the mechanisms leading to fat infiltration of LMM and its relation to spinal function. Further studies should investigate whether specific treatment strategies are effective in reducing or preventing fat infiltration of LMM.

摘要

背景

腰椎多裂肌(LMM)对脊柱运动和稳定性至关重要。腰痛(LBP)常与LMM中的脂肪浸润相关。LMM中脂肪浸润的增加可能导致腰椎功能障碍。本研究的目的是调查腰椎功能障碍的严重程度与LMM脂肪浸润的严重程度之间是否存在相关性。

方法

在一项横断面研究中,招募了42例急性或慢性LBP患者。使用LMM中脂肪堆积的三个标准对他们的MRI结果进行视觉评分和分级:0级(0-10%)、1级(10-50%)和2级(>50%)。测量腰椎矢状面活动范围、动态直立和坐姿控制、矢状面运动控制、身体感知和自我评估的功能障碍,以确定患者的腰椎功能障碍。

结果

本研究的主要结果是,腰椎多裂肌中脂肪浸润严重程度的增加与腰椎前屈活动范围的减小显著相关(p = 0.032)。未发现LMM中脂肪浸润的严重程度与运动控制受损、姿势控制、身体感知或自我评估的功能障碍之间存在显著相关性。

结论

这是第一项研究LMM中脂肪浸润严重程度与腰椎功能障碍严重程度之间关系的研究。本研究结果将有助于理解导致LMM脂肪浸润的机制及其与脊柱功能的关系。进一步的研究应调查特定的治疗策略是否能有效减少或预防LMM的脂肪浸润。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d155/5223418/15673599c738/12891_2016_1376_Fig1_HTML.jpg

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