Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China.
Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University (Third Military Medical University), Chongqing, 400038, People's Republic of China.
J Orthop Surg Res. 2024 Jan 31;19(1):102. doi: 10.1186/s13018-024-04593-3.
Patients with degenerative spinal deformity often experience symptoms that seriously affect their quality of life, such as low back pain and dysfunction. This study aimed to investigate the relationship between paravertebral muscle function and pelvic incidence (PI) and their effect on health-related quality of life (HRQL) in patients with degenerative spinal deformity.
A total of 112 patients with degenerative spinal deformity in Southwest Hospital (Chongqing, China) were enrolled. They were divided into groups according to PI angle: high (PI > 60°, n = 37), normal (PI 50°-60°, n = 31), and low (PI < 50°, n = 44). Paravertebral muscle strength and endurance were assessed using the prone external fixation test frame. The sagittal vertical axis (SVA) was measured on X-rays of the spine in an anterolateral position, and all subjects were assessed with the Oswestry Disability Index (ODI), Roland-Morris questionnaire (RMQ), and 36-Item Short Form Health Survey (SF-36). Pearson or Spearman coefficients were used to assess the relationship of paravertebral muscle function with SVA, PI, and health-related quality of life.
Maximal voluntary exercise (MVE) in the high-PI group was significantly lower than the MVE of both the normal- and low-PI groups (p < 0.05). There was no significant difference in MVE between the normal- and low-PI groups (p > 0.05). There was no significant difference in endurance time, SVA, ODI, RMQ, and SF-36 among the three groups. Paravertebral muscle MVE was negatively correlated with PI, SVA, ODI, and RMQ (r = - 0.193, - 0.210, - 0.283, - 0.277, p < 0.05). Endurance time of paravertebral muscle was also negatively correlated with SVA, ODI, and RMQ (r = - 0.200, - 0.420, - 0.348, p < 0.05) and positively correlated with SF-36 (r = 0.245, p < 0.05). In addition, paravertebral muscle MVE was positively correlated with the physical functioning score of the SF-36 (r = 0.251, p < 0.05), and the endurance time of paravertebral muscle was positively correlated with the physical functioning, physical role, bodily pain, and social function scores of the SF-36 (r = 0.342, 0.230, 0.209, 0.256, p < 0.05).
High PI may serve as a risk factor for decreased paraspinal muscle strength in patients with degenerative spinal deformities. Early and targeted exercises focusing on paraspinal muscle strength and endurance could potentially be of positive significance in slowing down the progression of sagittal imbalance, alleviating functional disorders, and increasing health-related quality of life in patients with degenerative spinal deformity.
患有退行性脊柱畸形的患者经常会出现严重影响其生活质量的症状，如腰痛和功能障碍。本研究旨在探讨椎旁肌功能与骨盆入射角（PI）之间的关系，以及它们对退行性脊柱畸形患者健康相关生活质量（HRQL）的影响。
共纳入重庆西南医院 112 例退行性脊柱畸形患者。根据 PI 角度将他们分为三组：高（PI>60°，n=37）、正常（PI 50°-60°，n=31）和低（PI<50°，n=44）。使用俯卧位外固定试验架评估椎旁肌力量和耐力。在脊柱侧位的前外侧位 X 光片上测量矢状垂直轴（SVA），所有受试者均采用 Oswestry 残疾指数（ODI）、Roland-Morris 问卷（RMQ）和 36 项简明健康调查量表（SF-36）进行评估。使用 Pearson 或 Spearman 系数评估椎旁肌功能与 SVA、PI 和健康相关生活质量之间的关系。
高 PI 组的最大自主运动（MVE）明显低于正常和低 PI 组（p<0.05）。正常和低 PI 组之间的 MVE 没有显著差异（p>0.05）。三组之间的耐力时间、SVA、ODI、RMQ 和 SF-36 没有显著差异。椎旁肌 MVE 与 PI、SVA、ODI 和 RMQ 呈负相关（r=-0.193、-0.210、-0.283、-0.277，p<0.05）。椎旁肌耐力时间也与 SVA、ODI 和 RMQ 呈负相关（r=-0.200、-0.420、-0.348，p<0.05），与 SF-36 呈正相关（r=0.245，p<0.05）。此外，椎旁肌 MVE 与 SF-36 的身体功能评分呈正相关（r=0.251，p<0.05），而椎旁肌耐力时间与 SF-36 的身体功能、身体角色、身体疼痛和社会功能评分呈正相关（r=0.342、0.230、0.209、0.256，p<0.05）。
高 PI 可能是退行性脊柱畸形患者椎旁肌无力的危险因素。早期针对椎旁肌力量和耐力的有针对性的锻炼可能对减缓矢状失衡的进展、缓解功能障碍以及提高退行性脊柱畸形患者的健康相关生活质量具有积极意义。
