Ilves Outi Elina, Neva Marko Henrik, Häkkinen Keijo, Dekker Joost, Kraemer William J, Tarnanen Sami, Kyrölä Kati, Ylinen Jari, Piitulainen Kirsi, Järvenpää Salme, Kaistila Tiina, Häkkinen Arja
Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Department of Orthopedics and Trauma, Tampere University Hospital, Tampere, Finland.
Neurospine. 2019 Jun;16(2):332-338. doi: 10.14245/ns.1836136.068. Epub 2018 Oct 15.
The aim of this study was to investigate changes in trunk muscle strength 12 months after lumbar spine fusion (LSF) compared to preoperative strength.
A total of 194 patients (mean±standard deviation [SD] age, 61±21 years) who underwent LSF participated in this prospective longitudinal study. Physical measurements of the participants were made before surgery and 12 months postoperatively. Isometric trunk extension and flexion strength was measured using a strain-gauge dynamometer in the standing position. Strength changes were calculated. Regression analysis was performed to explore which factors predicted strength levels at 12 months postoperatively.
The preoperative mean±SD extension strength was 205±144 N, which increased to 258±142 N (p<0.001) at the 12-month follow-up. Flexion strength increased from 295±172 N to 364±164 N (p<0.001). The preoperative extension/flexion strength ratio was 0.75±0.38 and remained similar (0.73±0.26) at 12 months postoperatively (p=0.39).
Although trunk muscle strength increased by 26% for extension and 23% for flexion at the 12-month postoperative follow-up, both values remained objectively low. In addition, flexion strength remained higher than extension strength, which indicates an imbalance between those muscle groups. Age, severe back pain, and low trunk muscle strength before surgery predicted low trunk muscle strength at 1 year after spinal fusion.
本研究旨在调查腰椎融合术（LSF）后12个月躯干肌肉力量与术前力量相比的变化。
共有194例接受LSF的患者（平均±标准差[SD]年龄，61±21岁）参与了这项前瞻性纵向研究。在手术前和术后12个月对参与者进行身体测量。使用应变片测力计在站立位测量等长躯干伸展和屈曲力量。计算力量变化。进行回归分析以探索哪些因素可预测术后12个月的力量水平。
术前平均±SD伸展力量为205±144 N，在12个月随访时增加至258±142 N（p<0.001）。屈曲力量从295±172 N增加至364±164 N（p<0.001）。术前伸展/屈曲力量比为0.75±0.38，术后12个月时保持相似（0.73±0.26）（p=0.39）。
尽管术后12个月随访时躯干肌肉伸展力量增加了26%，屈曲力量增加了23%，但这两个值客观上仍然较低。此外，屈曲力量仍高于伸展力量，这表明这些肌肉群之间存在不平衡。年龄、严重背痛和术前躯干肌肉力量低可预测脊柱融合术后1年躯干肌肉力量低。
