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[健康人群椎旁肌退变的影像学参数及影响因素]

[Radiographic parameters and influencing factors of paraspinal muscle degeneration in healthy people].

作者信息

Wang Wei, Li Weishi

机构信息

Department of Orthopedics, Tianjin Hospital, Tianjin, 300211, P. R. China.

Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Jul 15;38(7):880-888. doi: 10.7507/1002-1892.202402060.

Abstract

OBJECTIVE

To measure the paraspinal muscle parameters, explore the characteristics of paraspinal muscles, and investigate the influence factors of paraspinal muscle degeneration in healthy people.

METHODS

Eighty-two healthy Chinese people were prospectively recruited between February 2020 and November 2020, including 36 males and 46 females. The age ranged from 21 to 75 years, with a mean of 48.0 years. The height ranged from 150 to 183 cm, with a mean of 165.6 cm. The body mass ranged from 43 to 100 kg, with a mean of 65.4 kg. The body mass index (BMI) ranged from 16.7 to 32.4 kg/m , with a mean of 23.7 kg/m . Parameters of the paraspinal muscles (multifidus muscle, erector spinae muscle, and psoas major muscle) at L , L , and L levels were measured by MRI, including the relative total cross-sectional area (rtCSA), relative fatty cross-sectional area (rfCSA), relative signal intensity (rSI), and fatty infiltration (FI). The differences of paraspinal muscle parameters at different genders and different measurement levels were compared; Pearson or Spearman correlation analysis was used to explore the relationship between paraspinal muscle parameters and age, height, body mass, BMI.

RESULTS

From L to L level, the rtCSA and rfCSA of multifidus muscle and psoas major muscle as well as the rfCSA of erector spinae muscle increased, while rtCSA of erector spinae muscle decreased. The FI and rSI of paraspinal muscles increased gradually. The parameters of paraspinal muscles at L and L levels were significantly different from those at L levels ( <0.05). There were significant differences in rtCSA and rfCSA of multifidus muscle, rtCSA, FI, and rSI of erector spinae muscle as well as rtCSA, rfCSA, and FI of psoas major muscle between L and L levels ( <0.05). Compared with males, the rfCSA and FI of multifidus muscle, FI of erector spinae muscle, and FI of psoas major muscle were significantly higher in females, while the rtCSA of psoas major muscle was significantly lower ( <0.05). Age was significantly negatively correlated with rtCSA of paraspinal muscles ( <0.05), but significantly positively correlated with FI of paraspinal muscles, rfCSA and rSI of multifidus and erector spinae muscles ( <0.05). Height was significantly negatively correlated with rfCSA and FI of paraspinal muscles ( <0.05).

CONCLUSION

The degree of paraspinal muscle degeneration increases gradually along the spine axis from head to tail. Paraspinal muscle degeneration is related to age, height, and gender. The relationship between the body mass, BMI and paraspinal muscle degeneration needs further study.

摘要

目的

测量椎旁肌参数,探究椎旁肌的特征,并调查健康人群椎旁肌退变的影响因素。

方法

2020年2月至2020年11月前瞻性招募了82名健康中国人,其中男性36名,女性46名。年龄范围为21至75岁,平均48.0岁。身高范围为150至183厘米,平均165.6厘米。体重范围为43至100千克,平均65.4千克。体重指数(BMI)范围为16.7至32.4千克/米²,平均23.7千克/米²。通过MRI测量L₁、L₂和L₃水平的椎旁肌(多裂肌、竖脊肌和腰大肌)参数,包括相对总横截面积(rtCSA)、相对脂肪横截面积(rfCSA)、相对信号强度(rSI)和脂肪浸润(FI)。比较不同性别和不同测量水平下椎旁肌参数的差异;采用Pearson或Spearman相关性分析来探究椎旁肌参数与年龄、身高、体重、BMI之间的关系。

结果

从L₁到L₃水平,多裂肌和腰大肌的rtCSA和rfCSA以及竖脊肌的rfCSA增加,而竖脊肌的rtCSA降低。椎旁肌的FI和rSI逐渐增加。L₂和L₃水平的椎旁肌参数与L₁水平的参数有显著差异(P <0.05)。L₁和L₂水平之间,多裂肌的rtCSA和rfCSA、竖脊肌的rtCSA、FI和rSI以及腰大肌的rtCSA、rfCSA和FI存在显著差异(P <0.05)。与男性相比,女性多裂肌的rfCSA和FI、竖脊肌的FI以及腰大肌的FI显著更高,而腰大肌的rtCSA显著更低(P <0.05)。年龄与椎旁肌的rtCSA显著负相关(P <0.05),但与椎旁肌的FI、多裂肌和竖脊肌的rfCSA和rSI显著正相关(P <0.05)。身高与椎旁肌的rfCSA和FI显著负相关(P <0.05)。

结论

椎旁肌退变程度从头部到尾部沿脊柱轴逐渐增加。椎旁肌退变与年龄、身高和性别有关。体重、BMI与椎旁肌退变之间的关系需要进一步研究。

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