Kose Halil Cihan, Aydin Serdar Onur
Department of Pain Medicine, Health Science University Kocaeli City Hospital, 41060 Kocaeli, Turkey.
Department of Neurosurgery, Health Science University Dr. Lutfi Kirdar Training and Research Hospital, 34120 Istanbul, Turkey.
J Clin Med. 2023 Sep 22;12(19):6122. doi: 10.3390/jcm12196122.
Cross-sectional area (CSA) and signal intensity ratio (SIR) of the multifidus muscle (MFM) on magnetic resonance imaging (MRI) was used to evaluate the extent of injury and atrophy of the MFM in patients with negative treatment outcomes following microlumbar discectomy (MLD). Negative treatment outcome was determined by pain score improvement of <50% compared to baseline. Patients in groups 1, 2, and 3 were evaluated at <4 weeks, 4-24 weeks, and >24 weeks postoperatively, respectively. The associations between the follow-up, surgery time and the changes in the MFM were evaluated. A total of 79 patients were included, with 22, 27, and 30 subjects in groups 1, 2, and 3, respectively. The MFM SIR of the ipsilateral side had significantly decreased in groups 2 ( = 0.001) and 3 ( < 0.001). The ipsilateral MFM CSA significantly decreased postoperatively in groups 2 ( = 0.04) and 3 ( = 0.006). The postoperative MRI scans found significant MFM changes on the ipsilateral side in patients with negative treatment outcomes regarding pain intensity following MLD. As the interval to the postoperative MRI scan increased, the changes in CSA of the MFM and change in T2 SIR of the MFM showed a tendency to increase.
采用磁共振成像（MRI）测量多裂肌（MFM）的横截面积（CSA）和信号强度比（SIR），以评估微创腰椎间盘切除术（MLD）治疗效果不佳患者的MFM损伤和萎缩程度。治疗效果不佳的判定标准为与基线相比疼痛评分改善<50%。第1组、第2组和第3组患者分别在术后<4周、4 - 24周和>24周进行评估。评估随访时间、手术时间与MFM变化之间的关联。共纳入79例患者，第1组、第2组和第3组分别有22例、27例和30例受试者。第2组（P = 0.001）和第3组（P < 0.001）患侧的MFM SIR显著降低。第2组（P = 0.04）和第3组（P = 0.006）患侧的MFM CSA术后显著降低。术后MRI扫描发现，MLD术后疼痛强度治疗效果不佳的患者患侧MFM有显著变化。随着术后MRI扫描间隔时间的增加，MFM的CSA变化和MFM的T2 SIR变化呈增加趋势。
