脊柱侧凸椎旁肌肌纤维不对称性分布的研究

The study on fiber transformations in paravertebral muscle of adolescent idiopathic scoliosis

目的 对特发性脊柱侧凸两侧椎旁肌肌纤维分布进行比较 ,并探讨其与脊柱侧凸病因学可能存在的关系。方法 本实验分三组 ,特发性脊柱侧凸组 :2 0例 ,平均年龄 15 .3岁 ,平均Cobb角为 5 6 .8° ,顶椎位于T7～12 。其中Cobb角 >5 0° 11例 ,Cobb角≤ 5 0° 9例。先天性脊柱侧凸组 :11例 ,平均年龄 13.9岁 ,平均Cobb角为 6 6 .7° ,顶椎位于T7～12 。对照组 :取 10例非脊柱侧凸病例作为对照。特发性脊柱侧凸和先天性脊柱侧凸组取顶椎区两侧椎旁肌 ,对照组取非病变区两侧椎旁肌 ,进行病理分析。结果 特发性脊柱侧凸和先天性脊柱侧凸组凸侧椎旁肌Ⅰ型肌纤维含量和横截面积均显著大于凹侧 (P <0 .0 5 ) ,对照组两侧无显著差异 (P >0 .0 5 ) ,特发性脊柱侧凸组中Cobb角 >5 0°的病例凸侧Ⅰ型肌纤维含量显著高于Cobb角≤ 5 0°的病例 (P <0 .0 5 )。

Objective To study the fiber transformations in paravertebral muscle of adolescent idiopathic scoliosis and analyze its relationship with the aetiology of adolescent idiopathic scoliosis. Methods There were 20 cases in adolescent idiopathic scoliosis group with average age of 15.3 years old and average Cobb angle of 56.8°, including 11 cases with Cobb angle >50°and 9 cases with Cobb angle ≤50°. The apex vertebra was from T 7 to T 12 . There were 11 cases in congenital scoliosis group with average age of 13.9 years old and average Cobb angle of 66.7°. The apex vertebra was from T 7 to T 12 . There were 10 cases without scoliosis in control group. The paravertebral muscles in apex vertebral region of adolescent idiopathic scoliosis and congenital scoliosis groups and in non diseased region of control group were pathologically analyzed. Results The percentage and cross sectional area of type Ⅰ fibers on the convex side were more than those on the concave side in adolescent idiopathic scoliosis and congenital scoliosis groups(P<0.05),but there was no significant difference in control group(P> 0.05 ). In adolescent idiopathic scoliosis group, type Ⅰ fibers on the convex side in cases with Cobb angle>50° were more numerous than those in cases with Cobb angle≤50°(P<0.05). Conclusion The asymmetry of distribution of paravertebral muscular fibers is secondary to idiopathic scoliosis.