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健康个体、退行性腰椎侧弯患者和腰椎管狭窄症患者椎旁肌参数的差异及其与健康相关生活质量的相关性

The Difference in Paraspinal Muscle Parameters and the Correlation with Health-Related Quality of Life among Healthy Individuals, Patients with Degenerative Lumbar Scoliosis and Lumbar Spinal Stenosis.

作者信息

Liu Yinhao, Yuan Lei, Zeng Yan, Ni Jiajun, Yan Shi

机构信息

Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Beijing 100191, China.

Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, 49 North Garden Road, Beijing 100191, China.

出版信息

J Pers Med. 2023 Sep 26;13(10):1438. doi: 10.3390/jpm13101438.

Abstract

(1) Background: Paraspinal muscle degeneration affects the quality of life in patients with degenerative lumbar scoliosis (DLS) and lumbar spinal stenosis (LSS). We aimed to describe the characteristics and differences in the paraspinal muscle parameters between patients with DLS and LSS and investigate their correlation with health-related quality of life (HRQOL). (2) Methods: There were forty-four participants in each group, namely the DLS, LSS, and healthy groups, who were matched at a ratio of 1:1 according to age, sex, and BMI. Differences in paraspinal muscle parameters among the three groups were compared using analysis of variance or the Mann-Whitney U test, and paraspinal muscle degeneration and HRQOL were analyzed using Spearman's correlation analysis. (3) Results: In the upper lumbar, the psoas (PS), quadratus lumborum (QL), and multifidus (MF) cross-sectional area (CSA) in the DLS group were smaller than those in the other groups. In the lower lumbar region, the CSA of the PS, QL, erector spinae (ES), and gross CSA (GCSA) of the MF in the DLS group were not significantly different from those in the LSS group. These values were lower than those observed in the healthy group. The lean muscle fat index (LMFI) of the MF and ES groups was higher than those of the other groups. Regarding HRQOL, we found that PS and MF CSA were strongly associated with HRQOL in healthy individuals; however, only MF was associated with HRQOL in the LSS group. (4): Conclusion: PS in the upper lumbar region and MF degeneration were more severe in patients with DLS than in those with LSS. ES degeneration was similar between the LSS and DLS groups. MF muscle atrophy in patients with LSS and asymmetric changes in the MF in DLS are associated with quality of life.

摘要

(1) 背景:椎旁肌退变影响退行性腰椎侧弯(DLS)和腰椎管狭窄症(LSS)患者的生活质量。我们旨在描述DLS和LSS患者椎旁肌参数的特征及差异,并研究它们与健康相关生活质量(HRQOL)的相关性。(2) 方法:每组有44名参与者,即DLS组、LSS组和健康组,根据年龄、性别和体重指数按1:1的比例匹配。使用方差分析或曼-惠特尼U检验比较三组之间椎旁肌参数的差异,并使用Spearman相关分析分析椎旁肌退变与HRQOL。(3) 结果:在腰椎上段,DLS组的腰大肌(PS)、腰方肌(QL)和多裂肌(MF)横截面积(CSA)小于其他组。在腰椎下段,DLS组的PS、QL、竖脊肌(ES)的CSA以及MF的总CSA(GCSA)与LSS组无显著差异。这些值低于健康组。MF和ES组的瘦肌肉脂肪指数(LMFI)高于其他组。关于HRQOL,我们发现健康个体中PS和MF CSA与HRQOL密切相关;然而,在LSS组中只有MF与HRQOL相关。(4) 结论:DLS患者腰椎上段的PS和MF退变比LSS患者更严重。LSS组和DLS组之间的ES退变相似。LSS患者的MF肌肉萎缩和DLS患者MF的不对称变化与生活质量相关。

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