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不同年龄段腰椎退行性疾病中脊柱旁肌退变的特征。

Characteristics of paraspinal muscle degeneration in degenerative diseases of the lumbar spine at different ages.

机构信息

Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun 130031, Jilin, China.

Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun 130031, Jilin, China.

出版信息

Clin Neurol Neurosurg. 2022 Dec;223:107484. doi: 10.1016/j.clineuro.2022.107484. Epub 2022 Oct 21.

Abstract

OBJECTIVE

To analyze the relationship between gender, age, and the degree of lumbar degenerative disease.

METHODS

290 patients with Lumbar spinal stenosis and sciatica were analyzed. Sixty patients without sciatica were collected in the control group. Patient demography including age, gender, body mass index (BMI), serum calcium, and triglyceride level was acquired. The cross-sectional area (CSA) and percentage of fat infiltration area (Intermuscular adipose tissue (IMat%) of paraspinal muscles at the L4-5 level were measured using MRI imaging. The patients were divided into five age groups: A (18-30 years old), B (31-40 years old), C (41-50 years old), D (51-60 years old), and E (> 60 years old). Analysis of variance (ANOVA) and LSD was used to analyze differences among subgroups. Student's t-test was used to compare MCSA and fat CSA in the two groups. P < 0.05 was statistically significant.

RESULTS

The paraspinal muscle CSA (MCSA) was significantly smaller in women (P < 0.05). Older age was associated with less MCSA and greater fatty infiltration in erector spinae and multifidus (MF) muscle (P < 0.05). Serum calcium and BMI were positively correlated with CSA of erector spinae muscle (P < 0.05), but not with muscle fat infiltration (P > 0.05). Although there was no significant difference in MCSA between the two groups, the fat infiltration (IMat%) in the disease group was significantly higher than in the control group (p < 0.05).

CONCLUSION

Lumbar degenerative diseases caused the degeneration of the paravertebral muscles, which mainly resulted in increased intramuscular fat infiltration, rather than changes in the overall MCSA.

摘要

目的

分析性别、年龄与腰椎退行性疾病严重程度的关系。

方法

对 290 例腰椎管狭窄症伴坐骨神经痛患者进行分析,收集 60 例无坐骨神经痛的患者作为对照组。获取患者年龄、性别、体质量指数(BMI)、血清钙、三酰甘油水平等一般资料。采用 MRI 影像学技术测量 L4-5 水平椎旁肌肉的横截面积(CSA)和脂肪浸润面积百分比(肌间脂肪组织(IMat%))。将患者分为 5 个年龄组:A(18-30 岁)、B(31-40 岁)、C(41-50 岁)、D(51-60 岁)和 E(>60 岁)。采用方差分析(ANOVA)和 LSD 进行亚组间差异分析,采用 Student's t 检验比较两组间的 MCSA 和脂肪 CSA。P<0.05 为差异有统计学意义。

结果

女性的椎旁肌肉 CSA(MCSA)明显较小(P<0.05)。年龄越大,竖脊肌和多裂肌(MF)的 MCSA 越小,脂肪浸润越多(P<0.05)。血清钙和 BMI 与竖脊肌 CSA 呈正相关(P<0.05),但与肌肉脂肪浸润无关(P>0.05)。两组间 MCSA 无明显差异,但疾病组的脂肪浸润(IMat%)明显高于对照组(p<0.05)。

结论

腰椎退行性疾病导致椎旁肌肉退变,主要表现为肌内脂肪浸润增加,而非整体 MCSA 改变。

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