Oh Chi-Hoon, Shin Dong-Eun, Yoon Siyeong, Oh Jongbeom, Lee Younghun, Lee Soonchul
Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea.
Front Med (Lausanne). 2023 Aug 1;10:1190021. doi: 10.3389/fmed.2023.1190021. eCollection 2023.
Paraspinal muscle asymmetry is associated with low back pain (LBP) problems. This study aimed to analyze skeletal muscle areas around the lumbar vertebra and compare the ratio of anterior and posterior muscles between patients with lumbar herniated nucleus pulposus (HNP) and healthy individuals using abdominal pelvic computed tomography (APCT).
After propensity score matching, 122 HNP patients and 122 non-HNP individuals were finally used for analyses. In APCT, axial cut images were collected at the level of the third lumbar vertebra lower end plate and only the muscle structure was obtained. After obtaining the muscular portion of their image, we measured the skeletal muscle area (SMA). Second, for analysis relation of sarcopenia and HNP, the status of low skeletal muscle mass was determined using a previously reported criteria based on APCT scans in the Republic of Korea.
From the analysis of the anterior-posterior muscles, the ratio of anterior SMA was statistically significantly larger in the HNP group than in the non-HNP group. Regarding the anatomical classification of trunk muscles, a statistically significant left-right imbalance to peripheral muscle in HNP men was observed. Regarding the status of low skeletal muscle mass, no statistical difference in prevalence between the two groups were observed. Moreover, no statistical difference in the prevalence of low skeletal muscle mass obesity was observed.
The lumbar flexor muscle was larger in HNP than others, showing trunk muscle imbalance. However, low skeletal muscle mass is not associated with HNP.
椎旁肌不对称与腰痛问题相关。本研究旨在分析腰椎周围的骨骼肌面积，并使用腹盆腔计算机断层扫描（APCT）比较腰椎间盘突出症（HNP）患者与健康个体的前后肌肉比例。
经过倾向评分匹配后，最终纳入122例HNP患者和122例非HNP个体进行分析。在APCT中，于第三腰椎下端平面采集轴向断层图像，仅获取肌肉结构。获取其图像的肌肉部分后，测量骨骼肌面积（SMA）。其次，为分析肌肉减少症与HNP的关系，根据韩国此前报道的基于APCT扫描的标准确定低骨骼肌量状态。
通过对前后肌肉的分析，HNP组的前SMA比例在统计学上显著高于非HNP组。关于躯干肌肉的解剖学分类，在HNP男性中观察到外周肌肉存在统计学上显著的左右不平衡。关于低骨骼肌量状态，两组之间的患病率未观察到统计学差异。此外，低骨骼肌量肥胖的患病率也未观察到统计学差异。
HNP患者的腰屈肌比其他人更大，表明躯干肌肉失衡。然而，低骨骼肌量与HNP无关。
