统计形态学分析显示单侧腰椎间盘突出症的脊柱旁肌肉具有特征性的不对称性。
Statistical morphological analysis reveals characteristic paraspinal muscle asymmetry in unilateral lumbar disc herniation.
机构信息
Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada.
PERFORM Centre, Concordia University, Montreal, Canada.
出版信息
Sci Rep. 2021 Aug 2;11(1):15576. doi: 10.1038/s41598-021-95149-6.
Growing evidence suggests an association of lumbar paraspinal muscle morphology with low back pain (LBP) and lumbar pathologies. Unilateral spinal disorders provide unique models to study this association, with implications for diagnosis, prognosis, and management. Statistical shape analysis is a technique that can identify signature shape variations related to phenotypes but has never been employed in studying paraspinal muscle morphology. We present the first investigation using this technique to reveal disease-related paraspinal muscle asymmetry, using MRIs of patients with a single posterolateral disc herniation at the L5-S1 spinal level and unilateral leg pain. Statistical shape analysis was conducted to reveal disease- and phenotype-related morphological variations in the multifidus and erector spinae muscles at the level of herniation and the one below. With the analysis, shape variations associated with disc herniation were identified in the multifidus on the painful side at the level below the pathology while no pathology-related asymmetry in cross-sectional area (CSA) and fatty infiltration was found in either muscle. The results demonstrate higher sensitivity and spatial specificity for the technique than typical CSA and fatty infiltration measures. Statistical shape analysis holds promise in studying paraspinal muscle morphology to improve our understanding of LBP and various lumbar pathologies.
越来越多的证据表明,腰椎旁脊柱肌肉形态与下腰痛(LBP)和腰椎病变之间存在关联。单侧脊柱疾病为研究这种关联提供了独特的模型,对诊断、预后和治疗都有影响。统计形状分析是一种可以识别与表型相关的特征性形状变化的技术,但从未用于研究脊柱旁肌肉形态。我们首次使用该技术进行研究,以揭示与疾病相关的脊柱旁肌肉不对称,使用 MRI 对 L5-S1 脊柱水平单侧椎间盘突出症和单侧腿痛患者进行检查。进行统计形状分析以揭示在突出水平和下方水平的多裂肌和竖脊肌中的与疾病和表型相关的形态变化。通过分析,在病变下方水平的疼痛侧多裂肌中发现了与椎间盘突出相关的形状变化,而在两个肌肉中均未发现与横截面积(CSA)和脂肪浸润相关的对称性病变。结果表明,与典型的 CSA 和脂肪浸润测量相比,该技术具有更高的灵敏度和空间特异性。统计形状分析有望用于研究脊柱旁肌肉形态,以提高我们对 LBP 和各种腰椎病变的理解。