Department of Spinal Surgery, Longyan First Hospital (Longyan First Affiliated Hospital of Fujian Medical University), Longyan, 364000, China.
BMC Musculoskelet Disord. 2024 Sep 3;25(1):702. doi: 10.1186/s12891-024-07808-0.
The effect of fat infiltration in the paraspinal muscles on cervical degenerative disease has been confirmed by multiple studies. However, little is known about fat infiltration in the paraspinal extensors in patients with acute cervical spinal cord injury (SCI). This study aimed to investigate the difference in paraspinal extensor fatty infiltration between patients with acute cervical SCI and healthy controls, and to further explore the protective role of the paravertebral extensor muscles in patients with cervical SCI.
A total of 50 patients with acute cervical SCI admitted to the emergency department from January 2019 to November 2023 were retrospectively analyzed, including 26 males and 24 females, with an average age of 59.60 ± 10.81 years. A control group of 50 healthy middle-aged and elderly individuals was also included, comprising 28 males and 22 females, with an average age of 55.00 ± 8.21 years. Cervical spine magnetic resonance imaging (MRI) was used to measure the cross-sectional areas of the superficial and deep cervical extensor muscles, the corresponding vertebral body cross-sectional areas, and the fat area within the superficial and deep extensor muscle groups using Image J software. Differences between the two groups were compared, and the cervical SCI patients were further analyzed based on the severity of the spinal cord injury and gender differences.
The deep fatty infiltration ratio (DFIR) and superficial fatty infiltration ratio (SFIR) at C4-C7 in the cervical SCI group were significantly higher than those in the control group (P < 0.001). The cross-sectional area of the functional deep extensor area (FDEA) relative to the vertebral body area (VBA) and the cross-sectional area of the functional superficial extensor area (FSEA) relative to the VBA at the C5 and C6 levels in the cervical SCI group were significantly lower than those in the control group (P < 0.001, P < 0.001, P = 0.034, P = 0.004 respectively). Among the cervical SCI patients, the cross-sectional areas of the deep extensor area (DEA) and the superficial extensor area (SEA) in males were significantly higher than those in females (P < 0.001). At the C6 and C7 levels, the FDEA/VBA and FSEA/VBA ratios in the male group were higher than those in the female group (P = 0.009, P = 0.022, P = 0.019, P = 0.005, respectively).
Patients with acute cervical SCI exhibit significantly higher fatty infiltration and a greater degree of paravertebral extensor muscle degeneration compared to healthy controls. This finding underscores the importance of the paravertebral extensor muscles in the context of cervical SCI and may guide future therapeutic strategies.
多项研究证实，脂肪浸润在椎间旁肌肉与颈椎退行性疾病有关。然而，关于急性颈脊髓损伤（cervical spinal cord injury，SCI）患者的椎旁伸肌脂肪浸润，人们知之甚少。本研究旨在探讨急性颈 SCI 患者与健康对照组之间椎旁伸肌脂肪浸润的差异，并进一步探讨颈椎 SCI 患者中椎旁伸肌的保护作用。
回顾性分析 2019 年 1 月至 2023 年 11 月因急性颈 SCI 就诊于我院急诊科的 50 例患者，其中男 26 例，女 24 例，平均年龄 59.60±10.81 岁。另纳入同期 50 例健康中老年人作为对照组，其中男 28 例，女 22 例，平均年龄 55.00±8.21 岁。采用颈椎磁共振成像（magnetic resonance imaging，MRI）测量颈 4-7 水平的浅层和深层颈伸肌、相应椎体的横截面积以及浅层和深层伸肌群内的脂肪面积，使用 Image J 软件进行分析。比较两组间的差异，并根据脊髓损伤的严重程度和性别对颈 SCI 患者进行进一步分析。
颈 SCI 组 C4-C7 的深层脂肪浸润比（deep fatty infiltration ratio，DFIR）和浅层脂肪浸润比（superficial fatty infiltration ratio，SFIR）明显高于对照组（P<0.001）。颈 SCI 组 C5、C6 水平的功能深层伸肌面积（functional deep extensor area，FDEA）与椎体面积（vertebral body area，VBA）比值以及功能浅层伸肌面积（functional superficial extensor area，FSEA）与 VBA 比值明显低于对照组（P<0.001，P<0.001，P=0.034，P=0.004）。在颈 SCI 患者中，男性的深层伸肌面积（deep extensor area，DEA）和浅层伸肌面积（superficial extensor area，SEA）明显高于女性（P<0.001）。在 C6、C7 水平，男性的 FDEA/VBA 和 FSEA/VBA 比值高于女性（P=0.009，P=0.022，P=0.019，P=0.005）。
与健康对照组相比，急性颈 SCI 患者的脂肪浸润程度明显更高，椎旁伸肌退变更严重。这一发现突出了椎旁伸肌在颈椎 SCI 中的重要性，并可能为未来的治疗策略提供指导。
