Radiology Department, Bicêtre Hospital, APHP, Kremlin-Bicêtre, France.
Complexité, Innovations, Activités Motrices et Sportives, CIAMS (EA4532), Université Paris-Saclay, Orsay, France.
J Anat. 2019 Jun;234(6):787-799. doi: 10.1111/joa.12978. Epub 2019 Mar 22.
The paraspinal compartment acts as a bone-muscle composite beam of the spine. The elastic properties of the paraspinal muscles play a critical role in spine stabilization. These properties depend on the subjects' posture, and they may be drastically altered by low back pain. Supersonic shear wave elastography can be used to provide quantitative stiffness maps (elastograms), which characterize the elastic properties of the probed tissue. The aim of this study was to challenge shear wave elastography sensitivity to postural stiffness changes in healthy paraspinal muscles. The stiffness of the main paraspinal muscles (longissimus, iliocostalis, multifidus) was measured by shear wave elastography at the lumbosacral level (L3 and S1) for six static postures performed by volunteers. Passive postures (rest, passive flexion, passive extension) were performed in a first shear wave elastography session, and active postures (upright, bending forward, bending backward) with rest posture for reference were performed in a second session. Measurements were repeated three times for each posture. Sixteen healthy young adults were enrolled in the study. Non-parametric paired tests, multiple analyses of covariance, and intra-class correlations were implemented for analysis. Shear wave elastography showed good to excellent reliability, except in the multifidus at S1, during bending forward, and in the multifidus at L3, during bending backward. Yet, during bending forward, only poor quality was recorded for nine volunteers in the longissimus. Significant intra- and inter-muscular changes were observed with posture. Stiffness significantly increased for the upright position and bending forward with respect to the reference values recorded in passive postures. In conclusion, shear wave elastography allows reliable assessment of the stiffness of the paraspinal muscles except in the multifidus at S1 and longissimus, during bending forward, and in the multifidus at L3, during bending backward. It reveals a different biomechanical behaviour for the multifidus, the longissimus, and the iliocostalis.
脊柱旁间隙充当脊柱的骨-肌复合梁。脊柱旁肌肉的弹性特性对脊柱稳定起着关键作用。这些特性取决于受试者的姿势，并且可能会因腰痛而发生剧烈变化。超声剪切波弹性成像可用于提供定量的硬度图（弹性图），其特征在于探测组织的弹性特性。本研究旨在挑战剪切波弹性成像对健康脊柱旁肌肉姿势僵硬变化的敏感性。通过剪切波弹性成像在志愿者进行的六个静态姿势下在腰骶部（L3 和 S1）测量主要脊柱旁肌肉（最长肌、髂肋肌、多裂肌）的硬度。在第一次剪切波弹性成像检查中进行被动姿势（休息、被动前屈、被动伸展），并进行主动姿势（直立、前屈、后屈），以休息姿势作为参考。每个姿势重复测量三次。共有 16 名健康的年轻人参加了这项研究。实施了非参数配对检验、多次协方差分析和组内相关分析。除了在 S1 的多裂肌、前屈时的最长肌和后屈时的 L3 多裂肌之外，剪切波弹性成像显示出良好到极好的可靠性。然而，在前屈时，最长肌仅记录到 9 名志愿者的质量较差。观察到与姿势相关的肌肉内和肌肉间的显著变化。与被动姿势记录的参考值相比，直立和前屈的刚度显著增加。总之，剪切波弹性成像可以可靠地评估脊柱旁肌肉的硬度，除了在 S1 的多裂肌、前屈时的最长肌和后屈时的 L3 多裂肌之外。它揭示了多裂肌、最长肌和髂肋肌的不同生物力学行为。
