Tamartash Hassan, Bahrpeyma Farid, Mokhtari Dizaji Manijhe
Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Medical Physics, Tarbiat Modares University, Tehran, Iran.
Clin Anat. 2023 Jan;36(1):36-41. doi: 10.1002/ca.23964. Epub 2022 Oct 24.
Different hypotheses have been proposed about the role of lumbar connective tissue in low back pain (LBP). However, none of the previous studies have examined the change in the elastic behavior of lumbar fascia in patients with LBP. The present study aimed to evaluate the changes in the elastic behavior of lumbar fascia in patients with chronic non-specific LBP based on ultrasound imaging. The sonographic strain imaging assessed the thoracolumbar fascia (TLF) of 131 human subjects (68 LBP and 63 non-LBP). Assessments were done at L2-L3 and L4-L5 levels bilaterally. The points were located 2 cm lateral to the midpoint of the interspinous ligament. There were no significant differences in age, sex, and BMI between LBP and healthy individuals. There is a strong inverse relationship between pain severity (r = -0.76, n = 68, p = 0.004) and the TLF elastic modulus coefficient. No significant relationship were observed between age (r = 0.053, n = 68, p = 0.600), BMI (r = -0.45, n = 68, p = 0.092), and gender (r = -0.09, n = 68, p = 0.231) with the TLF elasticity coefficient. The LBP group had a 25%-30% lower TLF elastic modulus coefficient than healthy individuals. The present study is the first to evaluate the elastic coefficient of TLF using the ultrasound imaging method. The study results showed that the TLF elastic coefficient in patients with LBP was reduced compared to healthy individuals and directly related to LBP severity.
关于腰椎结缔组织在腰背痛（LBP）中的作用，已经提出了不同的假设。然而，之前的研究均未考察腰背痛患者腰部筋膜弹性行为的变化。本研究旨在基于超声成像评估慢性非特异性腰背痛患者腰部筋膜弹性行为的变化。超声应变成像评估了131名受试者（68名腰背痛患者和63名非腰背痛患者）的胸腰筋膜（TLF）。在L2-L3和L4-L5水平双侧进行评估。测量点位于棘间韧带中点外侧2厘米处。腰背痛患者与健康个体在年龄、性别和体重指数方面无显著差异。疼痛严重程度与胸腰筋膜弹性模量系数之间存在很强的负相关关系（r = -0.76，n = 68，p = 0.004）。未观察到年龄（r = 0.053，n = 68，p = 0.600）、体重指数（r = -0.45，n = 68, p = 0.092）和性别（r = -0.09，n = 68，p = 0.231）与胸腰筋膜弹性系数之间存在显著关系。腰背痛组的胸腰筋膜弹性模量系数比健康个体低25%-30%。本研究是首次使用超声成像方法评估胸腰筋膜的弹性系数。研究结果表明，与健康个体相比，腰背痛患者的胸腰筋膜弹性系数降低，且与腰背痛严重程度直接相关。
