退变性腰椎滑脱患者腰部多裂肌退变与腰背痛的相关性研究

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Abstract Objective To analysis the correlation between lumbar multifidus muscle degeneration and Visual Analogue Score(VAS)，Oswestry disability index(ODI) in degenerative lumbar spondylolisthesis patients.Methods A total of 64 patients(24 males，40 females) with a mean age of (63.02±10.59) years(range，45～84 years) was included in this retrospective study.The mean cross-sectional area of lumbar multifidus muscle on both sides and the cross-sectional area of the fifth lumbar vertebra were measured on the MRI imaging and then the ratio was calculated.The severity of the fatty infiltration was also evaluated by MRI and 4 different degrees(grade 0，1，2，3)were determined.Patients were divided into two groups：group A(grade 0 or 1) and group B(grade 1 or 2).The VAS and ODI were cornpared between two groups.The correlations between the atrophy，fatty infiltration of multifidus muscle and VAS，ODI were analyzed.Results The mean ratio of multifidus muscle atrophy of all 64 cases was (0.78±0.05).The fatty infiltration of grade 0，1，2 and 3 in multifidus muscle were observed in 6，11，20 and 27 patients respectively.The mean VAS and ODI of all patients was (5.3±1.4) and (47.1±13.5)％.Patients in group A had significantly lower VAS and ODI than those in group A(P＝0.016 and 0.009).There was negative correlation between the ratio of multifidus muscle atrophy and VAS，ODI(r＝－0.43，P＝0.024；r＝－0.49，P＝0.004).Meanwhile，positive correlation was observed between the fatty infiltration and VAS，ODI(r＝0.53，P＝0.019；r＝0.44，P＝0.015).Conclusion There is a correlation between the severity of lumbar multifidus muscle degeneration and low back pain in patients with degenerative lumbar spondylolisthesis.The more severe of lumbar multifidus muscle degeneration indicates more severe low back pain and disability.

Key words： degenerative lumbar spondylolisthesis lumbar multifidus muscle muscle atrophy fatty infiltration low back pain

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	Wang Xinqiang
	Jia Ruigang
	Chen Yanying
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Wang Xinqiang,Jia Ruigang,Chen Yanying, et al. Correlation between Lumbar Multifidus Muscle Degeneration and Low Back Pain in Degenerative Lumbar Spondylolisthesis Patients[J]. sygkzz, 2017, 23(9): 777-780.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2017/V23/I9/777

［1］姜欢畅.退变性腰椎滑脱治疗的现状与争议［J］.中国矫形外科杂志，2010，18(15)：1285-1287.
［2］Macintosh JE，Valencia F，Bogduk N，et al.The morphology of the human lumbar multifidus［J］.Clin Biomech (Bristol，Avon)，1986，1(4)：196-204.
［3］白玉花，张静.磁共振成像技术定量评定老年下背痛患者多裂肌的萎缩［J］.中华物理医学与康复杂志，2014，36(1)：36-38.
［4］Hides J，Stanton W，Mendis MD，et al.The relationship of transversus abdominis and lumbar multifidus clinical muscle tests in patients with chronic low back pain［J］.Man Ther，2011，16(6)：573-577.
［5］Zotti MG，Boas FV，Clifton T，et al.Does pre-operative magnetic resonance imaging of the lumbar multifidus muscle predict clinical outcomes following lumbar spinal decompression for symptomatic spinal stenosis?［J/OL］.Eur Spine J，2017(2)［2017-02-08］.https：//www.ncbi.nlm.nih.gov/pubmed/?term＝Does＋pre-operative＋magnetic＋resonance＋imaging＋of＋the＋lumbar＋multifidus＋muscle＋predict＋clinical＋outcomes＋following＋lumbar＋spinal＋decompression＋for＋symptomatic＋spinal＋stenosis％3F.
［6］Kader DF，Wardlaw D，Smith FW.Correlation between the MRI changes in the lumbar multifidus muscles and leg pain［J］.Clin Radiol，2000，55(2)：145-149.
［7］邵诗泽，张恩忠，付松，等.腰骶段多裂肌的形态特点及功能意义［J］.中国临床解剖学杂志，2010，28(1)：17-19.
［8］Ward SR，Kim CW，Eng CM，et al.Architectural analysis and intraoperative measurements demonstrate the unique design of the multifidus muscle for lumbar spine stability［J］.J Bone Joint Surg(Am)，2009，91(1)：176-185.
［9］Brumagne S，Lysens R，Swinnen S，et al.Effect of paraspinal muscle vibration on position sense of the lumbosacral spine［J］.Spine (Phila Pa 1976)，1999，24(13)：1328-1331.
［10］Wilke HJ，Wolf S，Claes LE，et al.Stability increase of the lumbar spine with different muscle groups.A biomechanical in vitro study［J］.Spine (Phila Pa 1976)，1995，20(2)：192-198.
［11］Kjaer P，Bendix T，Sorensen JS，et al.Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?［J］.BMC Med，2007(5)：2.
［12］Dulor JP，Cambon B，Vigneron P，et al.Expression of specific white adipose tissue genes in denervation-induced skeletal muscle fatty degeneration［J］.FEBS Lett，1998，439(12)：89-92.
［13］Hodges P，Holm AK，Hansson T，et al.Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury［J］.Spine (Phila Pa 1976)，2006，31(25)：2926-2933.
［14］Ergun T，Sahin MS，Lakadamyali H.Evaluation of the relationship between L₅ S₁ spondylolysis and isthmic spondylolisthesis and lumbosacral-pelvic morphology by imaging via 2-and 3-dimensional reformatted computed tomography［J］.J Comput Assist Tomogr，2011，35(1)：9-15.
［15］程大为，葛鹏，申才良，等.磁共振成像下退变性腰椎滑脱不同节段多裂肌改变的研究［J］.中国矫形外科杂志，2016(13)：1164-1169.
［16］Kaariainen T，Taimela S，Aalto T，et al.The effect of decompressive surgery on lumbar paraspinal and biceps brachⅡ muscle function and movement perception in lumbar spinal stenosis：a 2-year follow-up［J］.Eur Spine J，2016，25(3)：789-794.