退行性腰椎侧凸与多裂肌退变的关联性研究

喻学科; 陈灿; 李凯; 陈春华; 胡晨波; 戴威; 陈品珍; 赵骏; 罗飞

doi:10.16016/j.2097-0927.202203240

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退行性腰椎侧凸与多裂肌退变的关联性研究

临床医学 | 更新时间：2026-01-09

- 退行性腰椎侧凸与多裂肌退变的关联性研究
- Correlation between degenerative lumbar scoliosis and multifidus muscle degeneration
- 陆军军医大学学报 2022年44卷第20期页码：2075-2081
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：骨科
  2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：放射科
- 作者简介：
  
  [ 罗飞，E-mail：13883846917@163.com LUO Fei, E-mail: 13883846917@163.com
- 基金信息：
  
  军队后勤科研重大项目(AWS17J004)
- DOI：10.16016/j.2097-0927.202203240
  中图分类号： R322.74;R445.2;R681.53
- 收稿：2022-03-28，
  
  修回：2022-05-30，
  
  纸质出版：2022-10-30
- 稿件说明：
移动端阅览
喻学科, 陈灿, 李凯, 等. 退行性腰椎侧凸与多裂肌退变的关联性研究[J]. 陆军军医大学学报, 2022,44(20):2075-2081.

Xueke YU, Can CHEN, Kai LI, et al. Correlation between degenerative lumbar scoliosis and multifidus muscle degeneration[J]. Journal of Army Medical University, 2022, 44(20): 2075-2081.
喻学科, 陈灿, 李凯, 等. 退行性腰椎侧凸与多裂肌退变的关联性研究[J]. 陆军军医大学学报, 2022,44(20):2075-2081. DOI： 10.16016/j.2097-0927.202203240.

Xueke YU, Can CHEN, Kai LI, et al. Correlation between degenerative lumbar scoliosis and multifidus muscle degeneration[J]. Journal of Army Medical University, 2022, 44(20): 2075-2081. DOI： 10.16016/j.2097-0927.202203240.

摘要

目的

通过磁共振(magnetic resonance imaging，MRI)对退行性腰椎侧凸(degenerative lumbar scoliosis，DLS)患者腰部多裂肌进行评估，分析其不同腰椎节段凸凹侧多裂肌退变特点及其与脊柱畸形程度的相关性。

方法

采用横断面研究设计方案，2019年3月至2021年6月于陆军军医大学第一附属医院公开招募45例退行性腰椎侧凸受试者(DLS组)和42例健康受试者(对照组)为研究对象。应用Image J软件测量计算两组人群磁共振T2WI上从L1~L2到L5~S1 5个节段椎间盘中央层面椎旁两侧多裂肌横截面积(cross-sectional area，CSA)、功能横截面积(functional cross-sectional area，FCSA)和脂肪浸润率(fat infiltration ratio，FIR)，通过脊柱全长X线片测量DLS组腰椎冠状位侧凸Cobb角。分析DLS组腰椎各节段多裂肌退变特点及其与腰椎侧凸Cobb角的相关性。

结果

DLS组L4~L5、L5~S1节段凸、凹侧多裂肌FCSA均小于对照组相同节段左右侧多裂肌FCSA均值，差异有统计学意义(

0.05)。DLS组L1~S1节段凸、凹侧多裂肌FIR均大于对照组相同节段左右两侧多裂肌平均FIR，差异有统计学意义(

0.05)。DLS组L3~L4、L4~L5、L5~S1节段凹侧多裂肌FCSA小于凸侧，差异有统计学意义(

0.05)。DLS组Cobb角与L4~L5、L5~S1节段凸凹侧多裂肌FCSA差异指数(FCSA difference index，FDI)呈正相关(

=0.310、0.559，

0.05)。

结论

DLS患者下腰椎(L4~L5及L5~S1)节段对应的多裂肌退变程度与侧凸畸形的程度呈正相关，且凹侧重于凸侧，提示多裂肌退变不是DLS的始动因素，可能是其代偿因素。

Abstract

Objective

To evaluate the lumbar multifidus muscle in patients with degenerative lumbar scoliosis (DLS) by magnetic resonance imaging (MRI)

and to analyze the degeneration features of lumbar multifidus muscle in the convex and concave sides of different lumbar segments and the correlation with severity of spinal deformity.

Methods

A cross-sectional trial was performed on 45 DLS subjects (DLS group) and 42 healthy individual (control group) who were recruited among the public by our hospital from March 2019 to June 2021. Image J software was employed to measure and calculate the cross-sectional area (CSA)

functional cross-sectional area (FCSA) and fat infiltration rate (FIR) of the multifidus muscles beside the central planes of the intervertebral discs of 5 lumbar segments

L1-L2 and L5-S1

on T2WI images. The Cobb angle of lumbar coronal scoliosis in DLS group was measured by full-length spinal X-ray series. The degeneration features of multifidus muscle in each segment of lumbar vertebrae in DLS group and their correlation with Cobb angle of lumbar scoliosis were analyzed.

Results

The FCSA of the convex and concave multifidus muscles at L4-L5 and L5-S1 levels were significantly smaller in the DLS group than the control group (

0.05). The FIR of the convex and concave multifidus muscles at L1-S1 levels were obviously higher in the DLS group than the control group (

0.05). The DLS group had statistically smaller FCSA in the concave side than the convex multifidus muscles at L3-L4

L4-L5 and L5-S1 levels (

0.05). In the DLS group

the Cobb angle was positively correlated with FCSA difference index of L4-L5 and L5-S1 levels (

=0.310

0.559

0.05).

Conclusion

In DLS patients

degeneration of multifidus muscle corresponding to the lower lumbar levels (L4-L5 and L5-S1) is positively correlated with the severity of scoliosis

and the condition is more serious in the concave side than the convex side. It is suggested that the degeneration of multidus muscle is not an initiating factor of DLS

but may be a compensatory factor.

关键词

Keywords

references

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