Boissière L, Moal B, Gille O, De-Roquefeuil E, Durieux M, Obeid I, Dousset V, Vital J-M, Skalli W
Laboratory of Biomechanics, Arts et Métiers ParisTech, ENSAM, boulevard de l'Hôpital, 75013 Paris, France; Spine Unit 1, Bordeaux University Hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France.
Laboratory of Biomechanics, Arts et Métiers ParisTech, ENSAM, boulevard de l'Hôpital, 75013 Paris, France.
Orthop Traumatol Surg Res. 2017 Apr;103(2):279-283. doi: 10.1016/j.otsr.2016.10.025. Epub 2017 Jan 10.
Lumbar spinal stenosis is degenerative disc disease most common manifestation. If stenosis degree seems poorly related to symptom severity, lumbar muscles role is recognized. Many studies report imaging methods, to analyze muscle volumes and fat infiltration (FI), but remain limited due to the difficulty to represent entire muscle volume variability. Recently a 3D muscle reconstruction protocol (using the deformation of a parametric specific object method (DPSO) and three-point Dixon images) was reported. It offers the ability to evaluate, muscles volumes and muscle FI.
To describe, in a lumbar spinal stenosis population, muscle volumes, muscle FI and lumbar spinal canal volume with 3D MRI images reconstructions.
Ten adults presenting L4-L5 lumbar stenosis, were included. After specific MRI protocol, three-dimensional, muscle and spinal canal, reconstructions were performed. Muscle (psoas and paraspinal muscles) volumes and fat infiltration (FI), the spinal canal volume, age, and height were correlated one to each other with Spearman correlation factor. An ANOVA was performed to evaluate the intervertebral level influence (P≤0.05).
Muscle volumes correlated with height (r=0.68 for psoas). Muscles FI correlated with age (r=0.66 for psoas) and lumbar spinal canal volume (r=0.91). Psoas and paraspinal volumes were maximum at L3-L4 level whereas FI increased from L1-L2 to L5-S1 level.
These first results illustrate the importance to consider muscles entirely and report correlations between muscles FI, lumbar spinal canal volume and age; and between muscle volumes and patients height. Muscle degeneration seems more related to muscle FI than muscle volume.
腰椎管狭窄是椎间盘退变疾病最常见的表现形式。如果狭窄程度似乎与症状严重程度关系不大，那么腰椎肌肉的作用就得到了认可。许多研究报道了成像方法来分析肌肉体积和脂肪浸润（FI），但由于难以呈现整个肌肉体积的变异性，这些研究仍然有限。最近报道了一种三维肌肉重建方案（使用参数特定对象变形方法（DPSO）和三点 Dixon 图像）。它能够评估肌肉体积和肌肉 FI。
通过三维 MRI 图像重建，描述腰椎管狭窄人群的肌肉体积、肌肉 FI 和腰椎管体积。
纳入 10 例患有 L4 - L5 腰椎管狭窄的成年人。经过特定的 MRI 方案后，进行三维肌肉和椎管重建。肌肉（腰大肌和椎旁肌）体积、脂肪浸润（FI）、椎管体积、年龄和身高通过 Spearman 相关系数相互关联。进行方差分析以评估椎间水平的影响（P≤0.05）。
肌肉体积与身高相关（腰大肌 r = 0.68）。肌肉 FI 与年龄（腰大肌 r = 0.66）和腰椎管体积（r = 0.91）相关。腰大肌和椎旁肌体积在 L3 - L4 水平最大，而 FI 从 L1 - L2 到 L5 - S1 水平增加。
这些初步结果说明了全面考虑肌肉的重要性，并报告了肌肉 FI、腰椎管体积与年龄之间以及肌肉体积与患者身高之间的相关性。肌肉退变似乎与肌肉 FI 的关系比与肌肉体积的关系更大。
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