School of Biomedical Sciences, The University of Queensland, Australia.
Biomechanics and Spine Research Group, Centre for Children's Health Research, Queensland University of Technology, Australia.
Spine (Phila Pa 1976). 2023 Dec 15;48(24):1717-1725. doi: 10.1097/BRS.0000000000004715. Epub 2023 Jul 11.
This is a case-control study of prospectively collected data.
To quantify paraspinal muscle size asymmetry in adolescent idiopathic scoliosis (AIS) and determine if this asymmetry is (i) greater than observed in adolescent controls with symmetrical spines; and (ii) positively associated with skeletal maturity using Risser grade, scoliosis severity using the Cobb angle, and chronological age in years.
AIS is a three-dimensional deformity of the spine which occurs in 2.5% to 3.7% of the Australian population. There is some evidence of asymmetry in paraspinal muscle activation and morphology in AIS. Asymmetric paraspinal muscle forces may facilitate asymmetric vertebral growth during adolescence.
An asymmetry index [Ln(concave/convex volume)] of deep and superficial paraspinal muscle volumes, at the level of the major curve apex (Thoracic 8-9 th vertebral level) and lower-end vertebrae ( LEV , Thoracic 10-12 th vertebral level), was determined from three-dimensional Magnetic Resonance Imaging of 25 adolescents with AIS (all right thoracic curves), and 22 healthy controls (convex=left); all female, 10 to 16 years.
Asymmetry index of deep paraspinal muscle volumes was greater in AIS (0.16±0.20) than healthy spine controls (-0.06±0.13) at the level of the apex ( P <0.01, linear mixed-effects analysis) but not LEV ( P >0.05). Asymmetry index was positively correlated with Risser grade ( r =0.50, P <0.05) and scoliosis Cobb angle ( r =0.45, P <0.05), but not age ( r =0.34, P >0.05). There was no difference in the asymmetry index of superficial paraspinal muscle volumes between AIS and controls ( P >0.05).
The asymmetry of deep apical paraspinal muscle volume in AIS at the scoliosis apex is greater than that observed at equivalent vertebral levels in controls and may play a role in the pathogenesis of AIS.
这是一项前瞻性收集数据的病例对照研究。
定量青少年特发性脊柱侧凸（AIS）患者的椎旁肌大小不对称，并确定这种不对称是否（i）大于对称性脊柱青少年对照组；（ii）与骨骼成熟度（使用 Risser 分级）、脊柱侧凸严重程度（使用 Cobb 角）和年龄（以年为单位）呈正相关。
AIS 是一种发生于澳大利亚人群中 2.5%至 3.7%的脊柱三维畸形。AIS 患者椎旁肌激活和形态存在一定的不对称性。不对称的椎旁肌力可能会在青春期促进不对称的椎体生长。
通过对 25 例 AIS 青少年（均为右胸弯）和 22 例健康对照组（凸侧=左侧）的三维磁共振成像，在主弯顶点（胸椎 8-9 椎体水平）和下位椎体（胸椎 10-12 椎体水平）确定深、浅层椎旁肌体积的不对称指数[Ln（凹侧/凸侧体积）]。所有患者均为女性，年龄为 10 至 16 岁。
AIS 患者深椎旁肌体积的不对称指数（0.16±0.20）大于健康脊柱对照组（-0.06±0.13）（P<0.01，线性混合效应分析），但在下位椎体（P>0.05）无差异。不对称指数与 Risser 分级（r=0.50，P<0.05）和脊柱侧凸 Cobb 角（r=0.45，P<0.05）呈正相关，但与年龄（r=0.34，P>0.05）无相关性。AIS 患者与对照组的浅椎旁肌体积不对称指数无差异（P>0.05）。
AIS 顶点处深椎旁肌体积的不对称性大于对照组相同节段的不对称性，可能在 AIS 的发病机制中起作用。
