Flicker P L, Fleckenstein J L, Ferry K, Payne J, Ward C, Mayer T, Parkey R W, Peshock R M
Department of Orthopaedics, University of Texas Southwestern Medical Center, Dallas.
Spine (Phila Pa 1976). 1993 Apr;18(5):582-6. doi: 10.1097/00007632-199304000-00010.
Methods for detecting recruitment patterns of the lumbar muscles during exercise in patients with chronic low back pain are limited. This article discusses the use of magnetic resonance imaging with Roman chair extension exercise to examine lumbar muscle usage in five normal volunteers, five chronic low back pain patients without surgery, and five chronic low back pain patients with surgery. Changes in signal intensities of psoas, multifidus, and longissimus/iliocostalis with graded exercise were measured at three lumbar disc levels. At rest, there was a difference between multifidus and longissimus/iliocostalis signal intensity in chronic low back pain subjects without surgery (P = 0.0162) and in chronic low back pain subjects with surgery (P = 0.0036), but not in normal subjects. At peak exercise, there was a difference in signal intensities between multifidus and longissimus/iliocostalis in all groups (normal volunteers, P = 0.0069; chronic low back pain patients without surgery, P = 0.0125; chronic low back pain patients with surgery, P = 0.0060). The exercise response was attenuated in chronic low back pain patients with surgery. Thus, MRI demonstrates static and dynamic differences in lumbar paraspinal musculature in chronic low back pain subjects compared to normal subjects.
检测慢性下腰痛患者运动期间腰椎肌肉募集模式的方法有限。本文讨论了利用磁共振成像结合罗马椅伸展运动，来检查5名正常志愿者、5名未经手术的慢性下腰痛患者以及5名接受过手术的慢性下腰痛患者的腰椎肌肉使用情况。在三个腰椎间盘水平测量了随着分级运动腰大肌、多裂肌和最长肌/髂肋肌信号强度的变化。静息时，未经手术的慢性下腰痛受试者（P = 0.0162）和接受过手术的慢性下腰痛受试者（P = 0.0036）的多裂肌和最长肌/髂肋肌信号强度存在差异，但正常受试者中无此差异。运动峰值时，所有组（正常志愿者，P = 0.0069；未经手术的慢性下腰痛患者，P = 0.0125；接受过手术的慢性下腰痛患者，P = 0.0060）的多裂肌和最长肌/髂肋肌信号强度均存在差异。接受过手术的慢性下腰痛患者的运动反应减弱。因此，与正常受试者相比，MRI显示了慢性下腰痛受试者腰椎旁肌肉组织的静态和动态差异。
