Ohba Tetsuro, Goto Go, Tanaka Nobuki, Oda Kotaro, Katsu Marina, Takei Hayato, Koyama Kensuke, Oba Hiroki, Haro Hirotaka
Department of Orthopaedic Surgery, University of Yamanashi, Yamanashi 4008510, Japan.
Department of Orthopaedic Surgery, Shinshu University School of Medicine, Nagano 3908621, Japan.
J Clin Med. 2022 Nov 30;11(23):7117. doi: 10.3390/jcm11237117.
Limb muscle strength asymmetry affects many physical abilities. The present study (1) quantified limb muscle asymmetry in patients with adolescent idiopathic scoliosis (AIS); (2) compared AIS patients with major thoracolumbar/lumbar (TL/L) or major thoracic (MT) curves; (3) examined correlations between limb muscle asymmetry and radiographic parameters. Patients with AIS with major TL/L curves (Lenke type 5C) and MT curves (Lenke Type 1A) who underwent posterior spinal fusion at our university hospitals were included. Patients with left hand dominance were excluded. Body composition was measured using whole-body dual-energy X-ray absorptiometry and asymmetry of left and right side skeletal muscles were evaluated. Upper extremity skeletal muscles on the dominant side were significantly larger than those on the nondominant side in both Lenke1A and 5C groups. The asymmetry of upper extremity skeletal muscles was significantly greater in the Lenke1A group than in the Lenke5C group. Additionally, the size of the asymmetry did not correlate with the magnitude of the major curve and rotational deformation but did correlate with a right shoulder imbalance in the Lenke1A group. These results suggest that in AIS with a constructive thoracic curve, right shoulder imbalance is an independent risk factor for upper extremity skeletal muscle asymmetry.
肢体肌肉力量不对称会影响多种身体能力。本研究（1）量化了青少年特发性脊柱侧凸（AIS）患者的肢体肌肉不对称情况；（2）比较了主要为胸腰段/腰段（TL/L）或主要为胸段（MT）曲线的AIS患者；（3）研究了肢体肌肉不对称与影像学参数之间的相关性。纳入了在我们大学医院接受后路脊柱融合术的主要为TL/L曲线（Lenke 5C型）和MT曲线（Lenke 1A型）的AIS患者。排除了左利手患者。使用全身双能X线吸收法测量身体成分，并评估左右侧骨骼肌的不对称性。在Lenke1A组和5C组中，优势侧上肢骨骼肌均显著大于非优势侧。Lenke1A组上肢骨骼肌的不对称性显著大于Lenke5C组。此外，不对称的程度与主要曲线的大小和旋转畸形无关，但与Lenke1A组的右肩失衡有关。这些结果表明，在具有结构性胸段曲线的AIS中右肩失衡是上肢骨骼肌不对称的独立危险因素。
