一种基于磁共振成像的腰椎肌肉分级，用于预测需要手术的患者的健康相关生活质量评分。
A Novel Magnetic Resonance Imaging-based Lumbar Muscle Grade to Predict Health-related Quality of Life Scores Among Patients Requiring Surgery.
机构信息
Hospital for Special Surgery, New York, NY.
Weill Cornell Medical College, New York, NY.
出版信息
Spine (Phila Pa 1976). 2021 Feb 15;46(4):259-267. doi: 10.1097/BRS.0000000000003833.
STUDY DESIGN
Retrospective cross-sectional cohort.
OBJECTIVE
The aim of this sudy was to determine whether muscle health measurements are associated with health-related quality of life scores (HRQOLs) for patients with lumbar spine pathology.
SUMMARY OF BACKGROUND DATA
Poor muscle health has been implicated as a source of pain/dysfunction for patients with lumbar spine pathology. Our aim was to quantify the relationship using muscle health measurements and HRQOLs.
METHODS
Three hundred and eight patients were included (mean age 57.7 ± standard deviation 18.2 years' old). We randomly selected patients into a derivation cohort (200) and validation cohort (108) to create our muscle health grade. We measured muscle health by the lumbar indentation value (LIV), goutallier classification (GC), and ratio of paralumbar muscle cross-sectional area over body mass index (PL-CSA/BMI). A muscle health grade was derived based on whether a measurement showed a statistically significant impact on visual analog scale back and leg pain (VAS-leg and VAS-leg), Oswestry Disability Index (ODI), short-form 12 physical health score (SF-12 PHS), short-form 12 mental health score (SF-12 MHS) and Patient-reported Outcomes Measurement Information System (PROMIS). A variety of statistical tools were used to determine whether there was a relationship between a measurement and HRQOLs.
RESULTS
In the derivation cohort, a muscle health grade was created based on the GC and PL-CSA/BMI ratio. For patients with a GC ≤2, one point was given. For patients with a PL-CSA/BMI ≥130, one point was given. Patients with 2 points were graded as "A" and 0 or 1 point were graded "B." Within the validation cohort of patients, there was a statistically significant higher PROMIS (mean 34.5 ± standard deviation 12.6 vs. 27.6 ± 14.0, P = 0.002), ODI (38.8 ± 18.3 vs. 45.8 ± 18.1, P = 0.05) and SF-12 PHS (34.7 ± 11.3 vs. 29.1 ± 6.3, P = 0.002) for patients with a good muscle health grade of "A."
CONCLUSION
This study offers an objective measurement of muscle health that correlates with HRQOLs for patients with lumbar spine pathology.Level of Evidence: 3.
研究设计
回顾性横截面队列研究。
目的
本研究旨在确定肌肉健康测量是否与腰椎病理患者的健康相关生活质量评分（HRQOL）相关。
背景资料总结
肌肉健康不良被认为是腰椎病理患者疼痛/功能障碍的一个来源。我们的目的是使用肌肉健康测量和 HRQOL 来量化这种关系。
方法
共纳入 308 例患者（平均年龄 57.7±18.2 岁）。我们将患者随机分为推导队列（200 例）和验证队列（108 例），以创建肌肉健康等级。我们通过腰椎凹陷值（LIV）、Goutallier 分级（GC）和腰旁肌横截面积与体重指数比（PL-CSA/BMI）来衡量肌肉健康。根据测量是否对视觉模拟量表腰背疼痛（VAS-腰和 VAS-腿）、Oswestry 残疾指数（ODI）、简短形式 12 项健康调查量表（SF-12 PHS）、简短形式 12 项心理健康调查量表（SF-12 MHS）和患者报告的结果测量信息系统（PROMIS）有统计学意义的影响，得出肌肉健康等级。使用各种统计工具来确定测量值与 HRQOL 之间是否存在关系。
结果
在推导队列中，根据 GC 和 PL-CSA/BMI 比值创建了肌肉健康等级。GC≤2 的患者记 1 分，PL-CSA/BMI≥130 的患者记 1 分。得 2 分的患者评为“A”，得 0 或 1 分的患者评为“B”。在验证队列的患者中，PROMIS（平均 34.5±12.6 与 27.6±14.0，P=0.002）、ODI（38.8±18.3 与 45.8±18.1，P=0.05）和 SF-12 PHS（34.7±11.3 与 29.1±6.3，P=0.002）的 PROMIS 评分显著更高，表明肌肉健康等级为“A”的患者具有更好的健康状况。
结论
本研究提供了一种客观的肌肉健康测量方法，与腰椎病理患者的 HRQOL 相关。
证据水平
3 级。
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