Vita Fabio, Donati Danilo, Pederiva Davide, Stella Salvatore Massimo, Tedeschi Roberto, Miceli Marco, Faldini Cesare, Galletti Stefano
IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic, Bologna, Italy.
Physical Therapy and Rehabilitation Unit, Policlinico Di Modena, Modena, Italy.
J Ultrasound. 2025 Jan 22. doi: 10.1007/s40477-025-00988-y.
The aim of this work is to demonstrate how the chronicity of low back pain can modify the trophism of the paraspinal muscles, by performing an ultrasound and MRI evaluation of the paraspinal muscles in the lumbar spine and correlating it to the time of onset of low back pain.
An ultrasound evaluation was carried out in the lumbar area with a 5-17 MHz linear probe of the paraspinal muscles of the lumbar region, compared with the MRI of the lumbar spine, in patients presented to our attention for chronic low back pain (> 6 months), from January 2021 to January 2023. In each patient, two series of images were analyzed, in the coronal and sagittal planes.
Between January 2021 and January 2023, a total of 79 patients were retrospectively evaluated by ultrasound for chronic low back pain. The patients, including 46 men and 33 women, had an average age of 51.6 years (min 24-max 74). In the evaluation of the profile of the paravertebral muscles, 22 patients (27.8%) showed hypotrophy of the paravertebral muscles with a concave profile, while the measurement of the thickness of the fascia showed an average thickness of 2.19 mm with a range between 1, 3 and 3.2 mm and an interquartile range of 1.7-2.65 mm. 77.2% of patients with a concave profile showed a thickness of the FTL > 2.5 mm, and an average duration of symptoms of approximately 15.3 months, to demonstrate a correlation between muscle hypotrophy, thickness of the FTL and duration of onset of symptoms.
In the evaluation of chronic low back pain carried out with MRI and ultrasound, the paravertebral musculature profile and the thickness of the thoracolumbar fascia are two instrumental data which, associated with the proposed classification and correlated to the clinical picture, allow to determine the chronicity of the pathological picture.
本研究旨在通过对腰椎旁肌肉进行超声和磁共振成像（MRI）评估，并将其与腰痛发作时间相关联，来证明慢性腰痛如何改变椎旁肌肉的营养状况。
2021年1月至2023年1月期间，对因慢性腰痛（>6个月）前来就诊的患者，使用5-17MHz线性探头对其腰椎区域的椎旁肌肉进行超声评估，并与腰椎MRI进行比较。对每位患者，在冠状面和矢状面分析两组图像。
2021年1月至2023年1月期间，共有79例患者因慢性腰痛接受了超声回顾性评估。患者包括46名男性和33名女性，平均年龄为51.6岁（最小24岁-最大74岁）。在评估椎旁肌肉轮廓时，22例患者（27.8%）显示椎旁肌肉萎缩，轮廓呈凹陷状，而筋膜厚度测量显示平均厚度为2.19mm，范围在1.3至3.2mm之间，四分位间距为1.7-2.65mm。77.2%轮廓呈凹陷状的患者FTL厚度>2.5mm，症状平均持续时间约为15.3个月，以证明肌肉萎缩、FTL厚度与症状发作持续时间之间的相关性。
在通过MRI和超声对慢性腰痛进行评估时，椎旁肌肉组织轮廓和胸腰筋膜厚度是两个重要数据，与所提出的分类相关联并与临床表现相关，有助于确定病理情况的慢性程度。
