Park Moon Soo, Moon Seong-Hwan, Kim Tae-Hwan, Oh JaeKeun, Lee Seon-Jong, Chang Ho Guen, Shin Jae-Hyuk
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Korea (the Republic of).
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea (the Republic of).
J Neurol Surg A Cent Eur Neurosurg. 2018 Jul;79(4):323-329. doi: 10.1055/s-0038-1639332. Epub 2018 Apr 16.
The treatment of atrophy or increased fat infiltration of the lumbar paraspinal muscles of patients with back pain, lumbar radiculopathy, or lumbar degenerative kyphosis is controversial. We review the literature on changes in the lumbar paraspinal muscles of these patients.
We searched Medline for relevant English-language articles and retrieved 25 articles published from 1993 to 2017 on changes in the lumbar paraspinal muscles; 21 met our study criteria. We categorized each article into three groups: randomized clinical trial, nonrandomized prospective study, or retrospective study.
We found 1 randomized prospective, 3 nonrandomized prospective, and 17 retrospective studies. Atrophies of the multifidus muscle are found at the level of the L5 vertebral body in patients with back pain, lumbar radiculopathy, and lumbar degenerative kyphosis. Increased fat infiltration to the multifidus muscle was found in the patients with lumbar radiculopathy or lumbar degenerative kyphosis. However, there are controversies over fat infiltration to the multifidus muscle in the patients with back pain and the efficiency of a paramedian surgical approach to prevent the atrophy of the multifidus muscle.
Atrophy of the multifidus muscle was found in patients with back pain, lumbar radiculopathy, and lumbar degenerative kyphosis. There was increased fat infiltration to the multifidus muscle in those patients with lumbar radiculopathy or lumbar degenerative kyphosis.
对于背痛、腰椎神经根病或腰椎退行性后凸患者的腰椎旁肌肉萎缩或脂肪浸润增加的治疗存在争议。我们回顾了关于这些患者腰椎旁肌肉变化的文献。
我们在Medline上搜索了相关的英文文章，检索到1993年至2017年发表的25篇关于腰椎旁肌肉变化的文章；其中21篇符合我们的研究标准。我们将每篇文章分为三组：随机临床试验、非随机前瞻性研究或回顾性研究。
我们发现1篇随机前瞻性研究、3篇非随机前瞻性研究和17篇回顾性研究。在背痛、腰椎神经根病和腰椎退行性后凸患者的L5椎体水平发现多裂肌萎缩。在腰椎神经根病或腰椎退行性后凸患者中发现多裂肌脂肪浸润增加。然而，对于背痛患者多裂肌的脂肪浸润以及旁正中手术方法预防多裂肌萎缩的有效性存在争议。
在背痛、腰椎神经根病和腰椎退行性后凸患者中发现多裂肌萎缩。在那些腰椎神经根病或腰椎退行性后凸患者中多裂肌脂肪浸润增加。
