Mattila M, Hurme M, Alaranta H, Paljärvi L, Kalimo H, Falck B, Lehto M, Einola S, Järvinen M
Spine (Phila Pa 1976). 1986 Sep;11(7):732-8. doi: 10.1097/00007632-198609000-00013.
Structural changes in the multifidus muscle were analyzed in 41 patients operated on for herniated intervertebral disc. Twelve cadavers served as controls. The two main findings follow: Both in the patients and in the controls the Type 2 muscle fibers were markedly and selectively smaller than the Type 1 fibers, which were of normal size for striated muscles, and the internal structure of Type 1 fibers showed so-called core-targetoid and/or moth-eaten change. Group atrophy or fiber-type grouping (indicators of denervation and reinnervation) were observed only in a few patients. The selective small size of the Type 2 fibers may indicate atrophy due to relative inactivity of the multifidus muscle both in the patients and in the controls, ie, it does not need to be related to the herniated disc. Definite proof for denervation of the multifidus muscle was not observed, but neither the possibility be excluded. The cause of the core-targetoid and/or moth-eaten changes cannot yet be determined with certainty, because these changes are not specific for any single entity but may be due, for example, to denervation, ischemia, or altered use of the muscles because of pain. In any case, because the changes were significantly more common in the patients than in the controls, they signal for a pathologic condition, the character of which remains to be elucidated.
对41例接受椎间盘突出症手术的患者的多裂肌结构变化进行了分析。12具尸体作为对照。主要有两项发现：在患者和对照组中，2型肌纤维均明显且选择性地比1型纤维小，而1型纤维对于横纹肌来说大小正常，且1型纤维的内部结构呈现出所谓的核心靶样和/或虫蚀样改变。仅在少数患者中观察到群组性萎缩或纤维类型群组化（去神经支配和再支配的指标）。2型纤维选择性的小尺寸可能表明，在患者和对照组中，多裂肌由于相对不活动而出现萎缩，即，这不一定与椎间盘突出有关。未观察到多裂肌去神经支配的确切证据，但也不能排除这种可能性。核心靶样和/或虫蚀样改变的原因尚不能确定，因为这些改变并非任何单一病因所特有，例如可能是由于去神经支配、缺血或因疼痛导致的肌肉使用改变。无论如何，由于这些改变在患者中比在对照组中明显更常见，它们预示着一种病理状态，其特征仍有待阐明。
