摘要
目的:比较腰椎间盘突出症患者腰骶部多裂肌退变情况。方法:招募健康志愿者和单侧L4,5腰椎间盘突出患者各35例,每组男20例,女15例,年龄25~55岁。健康志愿者组年龄(35.66±8.73)岁,BMI指数(21.85±1.94)kg/m2;腰椎间盘突出症患者组年龄(36.09±7.70)岁,BMI指数(21.50±1.78)kg/m2,VAS评分(4.40±0.88)分,病程(11.2±7.14)个月,采用核磁共振波谱成像分析,观察L4,5间隙腰骶部多裂肌脂肪比例、去脂肪化横截面积比例。结果:健康志愿者左侧多裂肌脂肪比例(0.169±0.035)%、去脂肪化横截面积比例(0.699±0.070)%和右侧多裂肌脂肪比例(0.168±0.031)%、去脂肪化横截面积比例(0.712±0.056)%比较,差异无统计学意义(P>0.05)。腰椎间盘突出症患者健侧多裂肌脂肪比例(0.173±0.021)%、去脂肪化横截面积比例(0.695±0.054)%和患侧多裂肌脂肪比例(0.228±0.027)%、去脂肪化横截面积比例(0.629±0.048)%比较,差异有统计学意义(P<0.05)。患者患侧与志愿者左右两侧多裂肌脂肪比例、去脂肪化横截面积比例比较,差异均有统计学意义(P<0.05);患者健侧与健康志愿者左右侧多裂肌脂肪比例、去脂肪化横截面积比例比较,差异均无统计学意义(P>0.05)。结论:单侧L4,5腰椎间盘突出症患侧腰骶部多裂肌存在退变,表现为多裂肌面积萎缩、脂肪浸润。
Objective:To compare the degeneration of lumbosacral multifidus muscle in patients with lumbar disc herniation.Methods:Magnetic Resonance Spectroscopy was performed on the multifidus muscle of 35 healthy volunteers and 35 patients with unilateral L4,5 lumbar disc herniation.There were 20 males and 15 females in each group,aged from 25 to 55 years old.In healthy volunteers,the mean age was(35.66±8.73)years old and the BMI was(21.85±1.94)kg/m2;in the patients,the mean age was(36.09±7.70)years old,the BMI was(21.50±1.78)kg/m2,the VAS score was(4.40±0.88)points,the course of disease was(11.2±7.14)months.The proportion of fat in the L4,5 lumbosacral multifidus muscle and the proportion of fat-suppressed cross-sectional area were observed by MRI,the differences of the observation indexes of the two groups were compared through data analysis.Results:In healthy volunteers,the proportion of fat on the left side of the multifidus muscle was(0.169±0.035)%,the proportion of fat removal cross-sectional area on the left side of the multifidus muscle was(0.699±0.070)%,the proportion of fat on the right side of the multifidus muscle was(0.168±0.031)%,and the proportion of fat removal cross-sectional area on the right side of the multifidus muscle was(0.712±0.056)%,there was no significant difference between the two sides(P>0.05).In patients,the proportion of fat on the healthy side of multifidus muscles was(0.173±0.021)%,the proportion of fat removal cross-sectional area on the healthy side of multifidus muscles was(0.695±0.054)%,the proportion of fat on the affected side of the multifidus muscle was(0.228±0.027)%,and the proportion of fat removal cross-sectional area on the affected side of the multifidus muscle was(0.629±0.048)%,the differences of the above indexes on both sides were statistically significant(P<0.05).There was a statistically significant difference in the proportion of multifidus muscle fat and the ratio of fat-suppressed cross-sectional area between the affected side and volunteers(P<0.05).There was no significant difference in fat ratio and fat-suppressed cross-sectional area ratio between the left and right sides of healthy volunteers and healthy side of patients(P>0.05).Conclusion:There is degeneration of lumbosacral multifidus muscle on the affected side of patients with unilateral L4,5 intervertebral disc herniation,featuring multifidus muscular atrophy and fat infiltration.
作者
胡零三
赵烨
张承哲
张敏
詹红生
元唯安
HU Ling-san;ZHAO Ye;ZHANG Cheng-zhe;ZHANG Min;ZHAN Hong-sheng;YUAN Wei-an(Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 201203,China)
出处
《中国骨伤》
CAS
CSCD
2020年第2期173-177,共5页
China Journal of Orthopaedics and Traumatology
基金
国家自然科学基金资助项目(编号:81403414)。
