Yun Jung Hae, Lee Dong Gyu
Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea.
Diagnostics (Basel). 2023 Jul 20;13(14):2423. doi: 10.3390/diagnostics13142423.
Aging is associated with muscle atrophy and fatty infiltration of skeletal muscle. The multifidus muscle stabilizes the lumbar spine and undergoes adipose accumulation with age, leading to functional decline in the elderly. Therefore, quantitative assessment of the multifidus muscle can be beneficial for the elderly when formulating treatment strategies and reducing future complications. Fifty-seven patients (mean age, 73.89 ± 6.09; 23 male patients) who underwent lumbar Magnetic resonance imaging (MRI) were prospectively recruited. The cross-sectional area (CSA) of the multifidus from the L2-S1 level and the CSA of the L4-5 level psoas muscle were measured. The functional CSA (fCSA) of the multifidus muscle was measured by excluding the fat infiltration area from the multifidus CSA. The CSA to fCSA ratio was obtained by multiplying 100 by the value obtained by dividing CSA by the fCSA. Pfrrmann classification was used to evaluate the degree of disc degeneration. The functional disability measurements were the Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), grip strength, and functional reach test (FRT). Pearson's correlation analysis was used to examine the relationship between the functional disability measurements and the multifidus muscle. The CSA to fCSA ratio value was relatively constant at each spine level and showed a significant correlation with the SPPB, grip strength, FRT, and psoas index ( < 0.05). However, degree of disc and multifidus muscle degeneration was not statistically significant. So, age-related changes play a significant role in developing back muscle fatty infiltration than disc degeneration. Moreover, Grip strength showed a stronger relationship with the quality of the multifidus muscle than other functional disability measurements.
衰老与肌肉萎缩及骨骼肌脂肪浸润相关。多裂肌对腰椎起稳定作用，且会随着年龄增长发生脂肪堆积，导致老年人功能下降。因此，对多裂肌进行定量评估有助于为老年人制定治疗策略并减少未来并发症。前瞻性招募了57例接受腰椎磁共振成像（MRI）检查的患者（平均年龄73.89±6.09岁；男性患者23例）。测量了L2 - S1水平多裂肌的横截面积（CSA）以及L4 - 5水平腰大肌的CSA。通过从多裂肌CSA中排除脂肪浸润区域来测量多裂肌的功能CSA（fCSA）。CSA与fCSA的比值通过将CSA除以fCSA所得值乘以100获得。采用Pfrrmann分级来评估椎间盘退变程度。功能残疾测量指标包括简短体能状况量表（SPPB）、伯格平衡量表（BBS）、握力和功能性伸展测试（FRT）。采用Pearson相关分析来检验功能残疾测量指标与多裂肌之间的关系。CSA与fCSA的比值在每个脊柱水平相对恒定，且与SPPB、握力、FRT和腰大肌指数显著相关（<0.05）。然而，椎间盘退变程度与多裂肌退变程度无统计学意义。因此，与椎间盘退变相比，年龄相关变化在背部肌肉脂肪浸润的发生中起更重要作用。此外，与其他功能残疾测量指标相比，握力与多裂肌质量的关系更强。
