Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Rd, Melbourne, VIC 3004, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, 99 Commercial Rd, Melbourne, VIC 3004, Australia.
Spine J. 2017 Nov;17(11):1729-1748. doi: 10.1016/j.spinee.2017.07.002. Epub 2017 Jul 26.
Although previous studies have investigated the association between paraspinal muscle morphology and low back pain (LBP), the results are conflicting.
This systematic review examined the relationship between size and composition of the paraspinal muscles and LBP.
STUDY DESIGN/SETTING: A systematic review was carried out.
No patient sample was required.
This review had no outcome measures.
A systematic search of electronic databases was conducted to identify studies investigating the association between the cross-sectional area or fatty infiltration of the paraspinal muscles (erector spinae, multifidus, psoas, and quadratus lumborum) and LBP. Descriptive data regarding study design and methodology were tabulated and a risk of bias assessment was performed.
Of the 119 studies identified, 25 met the inclusion criteria. Eight studies were reported as having low to moderate risk of bias. There was evidence for a negative association between cross-sectional area (CSA) of multifidus and LBP, but conflicting evidence for a relationship between erector spinae, psoas, and quadratus lumborum CSA and LBP. Moreover, there was evidence to indicate multifidus CSA was predictive of LBP for up to 12 months in men, but insufficient evidence to indicate a relationship for longer time periods. Although there was conflicting evidence for a relationship between multifidus fat infiltration and LBP, there was no or limited evidence for an association for the other paraspinal musculature.
This review found evidence that multifidus CSA was negatively associated with and predictive of LBP up to 12 months but conflicting evidence for an association between erector spinae, psoas, and quadratus lumborum CSA and LBP. To further understand the role of the paraspinal musculature in LBP, there is a need for high-quality cohort studies which extend over both the short and longer term.
尽管先前的研究已经探讨了脊柱旁肌肉形态与下腰痛（LBP）之间的关系，但结果存在争议。
本系统评价研究了脊柱旁肌肉的大小和组成与 LBP 之间的关系。
研究设计/设置：进行了系统评价。
不需要患者样本。
本综述没有观察指标。
对电子数据库进行系统检索，以确定研究脊柱旁肌肉（竖脊肌、多裂肌、腰大肌和腰方肌）横截面积或脂肪浸润与 LBP 之间关系的研究。列出了关于研究设计和方法的描述性数据，并进行了偏倚风险评估。
在确定的 119 项研究中，有 25 项符合纳入标准。8 项研究报告为低到中度偏倚风险。多裂肌横截面积（CSA）与 LBP 之间存在负相关的证据，但竖脊肌、腰大肌和腰方肌 CSA 与 LBP 之间的关系存在矛盾的证据。此外，有证据表明，多裂肌 CSA 在男性中可预测长达 12 个月的 LBP，但没有证据表明在更长的时间内存在相关性。尽管多裂肌脂肪浸润与 LBP 之间存在关系的证据存在矛盾，但其他脊柱旁肌肉的证据不足或有限。
本综述发现证据表明，多裂肌 CSA 与 LBP 呈负相关，并可预测长达 12 个月的 LBP，但竖脊肌、腰大肌和腰方肌 CSA 与 LBP 之间的关系存在矛盾的证据。为了进一步了解脊柱旁肌肉在 LBP 中的作用，需要进行高质量的队列研究，涵盖短期和长期。
