Department of Anesthesiology and Critical Care Medicine (Pain Center), Mie University Graduate School of Medicine.
Department of Rehabilitation Medicine, Mie University Graduate School of Medicine.
Int J Rehabil Res. 2022 Mar 1;45(1):33-38. doi: 10.1097/MRR.0000000000000507.
We investigated the relationship between paravertebral muscles and perimuscular connective tissues of the thoracolumbar fascia region and the four types of pain in patients suffering from chronic low back pain. A total of 17 patients with chronic low back pain participated in this study. Ultrasound imaging method was used to measure the thickness and echogenicity of the paravertebral muscles and perimuscular connective tissues. The measurement site considered in this study was located lateral to the midpoint between L2-3 and L4-5 spines. In addition, age, gender, BMI, numerical rating scale and the short-form McGill pain questionnaire 2 (includes questions with respect to continuous pain, intermittent pain, neuropathic pain and affective descriptors) were used for assessment. Statistical analysis was performed using correlation analysis and multiple regression analysis. A significant association was observed between paravertebral muscle echogenicity at L2-3 and the numerical rating scale (r = 0.499), between paravertebral muscle echogenicity at L4-5 with numerical rating scale (r = 0.538) and intermittent pain (r = 0.594), and between perimuscular connective tissue thickness at L2-3 and numerical rating scale (r = 0.762). We observed that the factor influencing perimuscular connective tissue thickness at L2-3 and L4-5 was intermittent pain (β = 0.513, β = 0.597, respectively). It was also observed that some of the imaging findings were associated with age and BMI. In conclusion, we observed that paravertebral muscle echogenicity and perimuscular connective tissue thickness in patients with chronic low back pain were associated with pain, especially intermittent pain.
我们研究了慢性下腰痛患者的椎旁肌肉和筋膜周围肌纤维组织与四种类型疼痛之间的关系。共有 17 名慢性下腰痛患者参与了这项研究。我们使用超声成像方法测量了椎旁肌肉和筋膜周围肌纤维组织的厚度和回声强度。本研究考虑的测量部位位于 L2-3 和 L4-5 脊柱中点的外侧。此外，我们还评估了患者的年龄、性别、BMI、数字评分量表和简短形式麦吉尔疼痛问卷 2（包含有关持续性疼痛、间歇性疼痛、神经性疼痛和情感描述符的问题）。我们使用相关性分析和多元回归分析进行了统计分析。结果显示，L2-3 处椎旁肌肉回声强度与数字评分量表呈显著正相关（r=0.499），L4-5 处椎旁肌肉回声强度与数字评分量表（r=0.538）和间歇性疼痛（r=0.594）呈显著正相关，L2-3 处筋膜周围肌纤维组织厚度与数字评分量表呈显著正相关（r=0.762）。我们发现，影响 L2-3 和 L4-5 筋膜周围肌纤维组织厚度的因素是间歇性疼痛（β=0.513，β=0.597）。此外，我们还观察到一些影像学发现与年龄和 BMI 有关。总之，我们发现慢性下腰痛患者的椎旁肌肉回声强度和筋膜周围肌纤维组织厚度与疼痛有关，尤其是间歇性疼痛。
