Huang Zhengqi, Bai Zhiqiang, Yan Jiansen, Zhang Yangyang, Li Shuangxing, Yuan Liang, Huang Dongsheng, Ye Wei
Department of Spine Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
World Neurosurg. 2022 Mar;159:e273-e284. doi: 10.1016/j.wneu.2021.12.041. Epub 2021 Dec 18.
The primary objective of the present study was to investigate the correlations among cervical paraspinal muscle morphology changes (fatty infiltration [FI] and muscle atrophy), cervical degeneration, and clinical features in patients with chronic nonspecific neck pain (CNSNP).
The magnetic resonance imaging data for 55 consecutive patients (average age, 35.80 years) with CNSNP were analyzed in the present cross-sectional study. The muscle morphology changes in 7 groups of paraspinal muscles, indicated by the adjusted cross-sectional area (aCSA) and FI ratio (FI%), were measured from C3/4 to C6/7. The correlations of these changes with disc degeneration, cervical balance (C2-C7 angle and cervical alignment), and clinical features (severity of neck pain and related disability and frequency of acute neck pain recurrence) were evaluated.
Significant correlations between FI% and aCSA and the grade of disc degeneration were observed in specific muscle groups at each level (P < 0.05). Morphological changes in the deep extensors and superficial paraspinal muscles were significantly associated with the cervical balance parameters (P < 0.05). The FI% showed a significant positive correlation, and the aCSA showed a significant negative correlation with the severity of neck pain and related disability (P < 0.05). Correlations between the morphological changes and the frequency of acute neck pain recurrence were also present in specific muscles (P < 0.05).
Correlations among the muscle morphology changes, cervical degeneration, and clinical features were established for patients with CNSNP. Muscle volume changes and FI might affect CNSNP diversely through different paraspinal muscle groups. These results imply a complex contribution of muscle morphological changes to cervical degeneration and the clinical course of CNSNP.
本研究的主要目的是调查慢性非特异性颈部疼痛（CNSNP）患者颈椎旁肌肉形态变化（脂肪浸润[FI]和肌肉萎缩）、颈椎退变与临床特征之间的相关性。
在本横断面研究中，分析了55例连续的CNSNP患者（平均年龄35.80岁）的磁共振成像数据。从C3/4至C6/7测量7组椎旁肌肉的肌肉形态变化，以调整后的横截面积（aCSA）和FI比率（FI%）表示。评估这些变化与椎间盘退变、颈椎平衡（C2-C7角和颈椎排列）以及临床特征（颈部疼痛严重程度、相关残疾和急性颈部疼痛复发频率）之间的相关性。
在每个水平的特定肌肉组中，观察到FI%和aCSA与椎间盘退变程度之间存在显著相关性（P<0.05）。深层伸肌和浅表椎旁肌肉的形态变化与颈椎平衡参数显著相关（P<0.05）。FI%与颈部疼痛严重程度和相关残疾呈显著正相关，aCSA与颈部疼痛严重程度和相关残疾呈显著负相关（P<0.05）。特定肌肉中形态变化与急性颈部疼痛复发频率之间也存在相关性（P<0.05）。
建立了CNSNP患者肌肉形态变化、颈椎退变与临床特征之间的相关性。肌肉体积变化和FI可能通过不同的椎旁肌肉组对CNSNP产生不同影响。这些结果暗示肌肉形态变化对颈椎退变和CNSNP临床病程有复杂的影响。
