脊髓型颈椎病患者颈椎旁肌退变评估及与矢状位参数的相关性分析

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Abstract

Objective To evaluate the imaging status of the paraspinal muscle in patients with cervical spondylotic myelopathy(CSM) and explore the effects on cervical sagittal balance and cervical range of motion with cervical MRI.Methods Thirty patients with cervical spondylotic myelopathy admitted to the Department of Orthopedics of the 83rd Group Military Hospital of the Army from January 2019 to January 2022 and 42 healthy people who underwent physical examination at the same time were selected as the observation group and the control group.In the observation group，there were 21 males and 9 females.The average age was (59.9±12.2) years，ranging from 30 to 78 years.In the control group，there were 23 males and 19 females.The average age was (55.7±10.1) years，ranging from 33 to 76 years.Based on the cervical MRI of the two groups of people，the cervical multifidus(MF)，cervical semispinalis cervicis(Scer) and cervical semispinalis capitis(Scap) were measured by Image J software，respectively.Cross sectional area(CSA) of Scap，splenius capitis(SPL)，and longus colli(LC) muscles，Effective crosssectional area(ECSA)，Relative cross-sectional area(RCSA) and fat infiltration(FI).15 cases of repeated measurement in two groups were selected for methodological research.Cervical sagittal balance parameters and cervical motion were measured based on standard cervical spine anterolateral and hyperextension and flexion X-ray films of patients in the observation group.A bilateral random model with intralcass correlation coefficient(ICC) was used to evaluate the consistency of Image J’s measurement of the level of paracyclinal muscle degeneration.The two-sample t test was used to compare the level of paracyclinal muscle degeneration between the two groups.Pearson correlation coefficient was used to evaluate the influence of cervical paracyclinal muscle degeneration on cervical imaging indexes in the observation group.Results The total range of intergroup and intragroup ICC measured by CSA and FI of cervical paravertebral muscle in observation group and control group was 0.771~0.956.The mean values of CSA and RCSA of multifidus muscle，semitinous capitis muscle and capicular pinus muscle in the observation group were significantly higher than those in the control group(P＜0.05)，but there was no significant difference in the average value of ECSA compared with the control group(P＞0.05).There was no significant difference in CSA，RCSA and ECSA between the observation group and the control group(P＞0.05).Compared with the control group，the average FI of multifidus muscle，cervical semispectinus muscle，cephalic semispectinus muscle and cervical longus muscle in the observation group were significantly higher(P＜0.05).ECSA of pinus capitis muscle was negatively correlated with cervical flexion angle(P＜0.05).There was no significant correlation between the other cervical paraspinal muscles and the sagittal parameters of the cervical spine.There was a significant negative correlation between CSA，ECSA and cervical lordosis angle(P＜0.05)，CSA and ECSA were significantly negatively correlated with cervical hyperextension angle and flexion extension angle(P＜0.05).The cervical longus muscle FI was significantly positively correlated with C_2~7 SVA of cervical spine(P＜0.05).Conclusion The Image J software measurement method based on cervical MRI can effectively reflect the imaging function of the paracyclinal muscles.The degeneration of the paracyclinal muscles in patients with cervical spondylotic myelopathy is mainly manifested by hypertrophy and fatty changes of the paracyclinal muscles，in which the degeneration of the capitis hemispinosus and the capitis clipper muscles is the most significant.The degeneration of the longus cervical muscle is closely related to sagittal disequilibrium of the cervical spine and limited hyperextension range of motion.

Key words： cervical spondylotic myelopathy cervical paraspinal muscles sagittal parameters

Corresponding Authors: Liang Qiudong

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	Su Wei
	Yang Sen
	Du Xiqi
	Zhang Ke
	Ma Xiaobei
	Liang Qiudong

Cite this article:

Su Wei,Yang Sen,Du Xiqi, et al. Evaluation of Cervical Paraspinal Muscle Degeneration and Its Correlation with Sagittal Parameters in Patients with Cervical Canal Stenosis[J]. sygkzz, 2023, 29(7): 577-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I7/577

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