Hopf C, Scheidecker M, Steffan K, Bodem F, Eysel P
Orthopaedic Department, Lubinus Klinik Kiel, Germany.
Eur Spine J. 1998;7(1):6-11. doi: 10.1007/s005860050019.
In a prospective experimental study the level gait activity scores of the iliocostalis lumborum, glutaeus medius, tensor fasciae latae, vastus lateralis and peronaeus longus muscles of both body sides were examined by computerized electromyography in 23 patients with idiopathic scoliosis before and after CD instrumentation. The pre- and postoperative findings were examined as to asymmetric patterns in muscle requisition during gait and the respective changes induced by the spinal correction. These results were compared with the corresponding results obtained in healthy subjects in two independent sessions with identical experimental conditions. A muscle activity asymmetry coefficient was defined to quantify the degree of left/right muscle activation asymmetry observed. Postoperatively a statistically significant reduction (P < 0.05) of a preoperatively strongly increased activity was found in the lumbar muscles of the convex side of double major scolioses as well as in the glutaeus medius and tensor fascia lata muscles of the concave side of thoracic curvatures. Both the casuistic and statistical analysis of the results of our study support the hypothesis that activity asymmetries observed in the paravertebral musculature in idiopathic scoliosis patients are the result of the scoliotic body deformities, with consequent asymmetries in the biomechanical force patterns of body postures and body motions, rather than an aetiological factor of scoliotic curvatures.
在一项前瞻性实验研究中，通过计算机化肌电图检查了23例特发性脊柱侧凸患者在CD内固定前后双侧腰髂肋肌、臀中肌、阔筋膜张肌、股外侧肌和腓骨长肌的步态活动水平评分。对术前和术后的结果进行了检查，以了解步态期间肌肉需求的不对称模式以及脊柱矫正引起的相应变化。将这些结果与在相同实验条件下的两个独立时间段内健康受试者获得的相应结果进行比较。定义了肌肉活动不对称系数，以量化观察到的左右肌肉激活不对称程度。术后发现，双主弯脊柱侧凸凸侧的腰部肌肉以及胸段侧弯凹侧的臀中肌和阔筋膜张肌中，术前强烈增加的活动有统计学意义的降低（P<0.05）。我们研究结果的病例分析和统计分析均支持以下假设：特发性脊柱侧凸患者椎旁肌肉组织中观察到的活动不对称是脊柱侧弯身体畸形的结果，从而导致身体姿势和身体运动的生物力学力模式不对称，而不是脊柱侧凸曲线的病因。
