摘要
目的:通过MRI分析椎旁肌横截面积与腰椎椎管狭窄症临床表现之间的相关性。方法:选取确诊为腰椎椎管狭窄症且资料齐全的患者159例(病例组)及同期在我院体检的健康人78名(对照组)为研究对象,用Image J2x软件测量MRI T2W1上L3~L5椎体下方平面的两侧椎旁腰大肌及多裂肌的横截面积。根据视觉模拟疼痛评分(VAS)及中医症候评分评估症状持续的时间、行走的距离、腿部放射性疼痛或者麻木。利用Pearson相关分析得到腰大肌及多裂肌横截面积的改变与临床症状的严重程度之间的相关性。结果:病例组在L5层面双侧多裂肌横截面积减小,差异有统计学意义(左侧,t=5.165,P=0.024<0.05;右侧,t=4.078,P=0.031<0.05);在L4~S1节段狭窄患者中,L5层面双侧多裂肌面积减小较为显著,差异有统计学意义(右侧,t=8.38,P=0.03<0.05;左侧,t=9.23,P=0.04<0.05);病例组L4~S1节段狭窄症患者中腰部疼痛及腿部疼痛的VAS评分较其他节段明显增高,差异有统计学意义(腰部疼痛,t=10.35,P=0.02<0.05;腿部疼痛,t=12.35,P=0.01<0.05),而各狭窄节段间歇性跋行程度(中医症候评分)差异无统计学意义(t=2.33,P=0.12>0.05)。通过Pearson相关分析可知:病例组患者中腰部疼痛及腿部疼痛的VAS评分较高者,其L5层面双侧多裂肌面积减小较为显著,有明显相关性(腰部疼痛,r=0.334,P<0.05;腿部疼痛,r=0.212,P<0.05)。结论:多裂肌在L5椎体平面横截面积的改变与腰椎椎管狭窄症患者腰及腿部疼痛程度有明显的相关性。
Objective:to examine the relationship between the paravertebral muscle cross-sectional area in MRI and the severity of symptoms in patients with lumbar spinal stenosis.Methods:159 patients(case group)with lumbar spinal stenosis and 78 patients without lumbar spinal stenosis(control group) were selected as the study subjects.The cross-sectional area of paravertebral muscles in the lower plane of L3~L5 vertebral body was measured by Image J2 x software on MRI T2 W1.The duration of symptoms,walking distance,radiation pain or numbness of legs were assessed according to visual analogue pain VAS scale and TCM symptom score.Pearson correlation analysis was used to obtain the correlation between the changes of paravertebral muscle cross-sectional area and the severity of clinical symptoms.Results:The cross-sectional area of bilateral multifidus muscle at L5 level decreased significantly in the two groups(left,t=5.165,P=0.024<0.05;right,t=4.078,P=0.031<0.05).In patients with L4~S1 segmental stenosis,the area of bilateral multifidus muscle at L5 level decreased significantly(right,t=8.38,P=0.03<0.05;left,t=9.23,P=0.04<0.05).The VAS scores of lumbar pain and leg pain were significantly higher than those of other segments(t=10.35,P=0.02<0.05;t=12.35,P=0.01<0.05),but there was no significant difference in the degree of intermittent trudging among narrow segments(t=2.33,P=0.12>0.05).Pearson correlation analysis showed that the area of bilateral multifidus muscle at L5 level decreased significantly in patients with higher VAS scores of lumbar pain and leg pain(lumbar pain,r=0.334,P<0.05;leg pain,r= 0.212,P<0.05).Conclusion:The change of the cross-sectional area of the multifidus muscle in L5 vertebral plane is significantly correlated with the pain degree of lumbar and leg in patients with lumbar spinal stenosis.
作者
都芳涛
于德国
方继峰
李兴晶
侯耀鹏
李广义
DU Fangtao;YU Deguo;FANG Jifeng;LI Xingjing;HOU Yaopeng;LI Guangyi(Affiliated Second People's Hospital of Liaocheng of Taishan Medical College,Linqing 252600,Shandong China)
出处
《中国中医骨伤科杂志》
CAS
2019年第7期32-36,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
山东省医药卫生科技发展计划项目(2017WS644)
关键词
腰椎椎管狭窄症
椎旁肌
横截面积
腰痛
lumbar spinal stenosis
paraspinal muscle
cross sectional area
low back pain
