摘要
目的:探讨单侧下背痛患者脊柱核心肌群的变化,为指导制定下背痛运动治疗方案提供一定的研究依据。方法:178例单侧下背痛患者根据病程长短分为急性期组(n=76)和慢性期组(n=102),采用Onis软件和Image J软件分析受试者腰部MRI图像,比较痛侧和非痛侧腰大肌(PM)、腰方肌(QL)、多裂肌(MF)和竖脊肌(ES)的肌肉横截面积(CSA)、肌肉平均信号强度(MSI)和脂肪浸润(FI)比例。结果:急性期组中,痛侧PM和ES的CSA较非痛侧肌肉小(P<0.05),MSI和FI比例较非痛侧肌肉高(P<0.05);慢性期组中,痛侧MF和ES的CSA较非痛侧肌肉小(P<0.05),MSI和FI比例较非痛侧肌肉高(P<0.05);急性期组痛侧ES的CSA较慢性期组痛侧肌肉大(P<0.05),MSI和FI比例较慢性期组痛侧肌肉低(P<0.05)。结论:急性期组和慢性期组患者存在痛侧竖脊肌的肌肉萎缩和脂肪浸润,慢性期组患者痛侧多裂肌萎缩明显。通过MRI研究LBP患者腰椎核心肌群情况,可为出现异常变化的肌肉设计针对性训练动作和方法提供依据,有助于尽快恢复脊柱力学,改善功能障碍。
Objective： To investigate the magnetic resonance imaging（MRI） changes of spinal core muscles in patients with unilateral low back pain（LBP）, and provide the evidence on the training plan for LBP. Method： One hundred and seventy-eight patients with unilateral LBP were enrolled and divided into acute group （n=76） and chronic group （n=102） according to the course of LBP, and the cross-sectional area （CSA）, muscle mean signal intensity （MSI） and fatty infiltration （FI） ratio between the painful side and non-painful side of psoas major （PM）, quadratus lumborum （QL）, multifidus （MF） and erector spinae （ES） of the lumbar were compared by using Onis and Image J software. Result： In acute group, CSAs of PM and ES for the painful side were smaller than that for the non-painful side （P〈0.05）, MSI and FI ratio for the painful side were higher than that for the non-painful side （P〈0.05）; In chronic group, CSAs of MF and ES for the painful side were smaller than that for the non-painful side （P〈0.05）, MSI and FI ratio for the painful side were higher than that for the non-painful side （P〈0.05）; CSA of ES for the painful side in acute group was larger than that in the painful side in chronic group （P〈0.05）, the MSI and FI ratio for the painful side in acute group were lower than that in chronic group （P〈0.05）. Conclusion： The ES of painful side for both groups had muscle atrophy and fatty infiltration, the MF of painful side for chronic group had muscle atrophy significantly. The MRI evidence of core muscles for LBP suggested that selective exercise training for abnormal muscle was helpful for recovery of spinal biomechanics and improvment of spinal function disorder.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2014年第10期933-937,共5页
Chinese Journal of Rehabilitation Medicine
关键词
下背痛
核心肌群
磁核共振
肌肉萎缩
脂肪浸润
low back pain
core muscle
magnetic resonance imaging
muscle atrophy
fatty infiltration
