脊柱侧凸椎旁肌肌纤维群化现象的研究

The study on fiber type grouping of paravertebral muscles in adolescent idiopathic scoliosis

目的对椎旁肌肌纤维群化现象与青少年特发性脊柱侧凸(adolescentidiopathic scoliosis,AIS)的发生、发展之间的关系进行研究.方法本实验分三组,AIS组:20例,平均年龄15.3岁,平均Cobb角56.8°.顶椎位于T7～12.其中Cobb角＞50°11例,Cobb角≤50°9例.先天性脊柱侧凸(congenital scoliosis,CS)组:11例,平均年龄13.9岁,平均Cobb角66.7°,顶椎位于T7～12.对照组:取10例非脊柱侧凸病例作为对照.AIS和CS组取顶椎区两侧椎旁肌,对照组取非病变区两侧椎旁肌行病理分析.结果AIS和CS组均存在凸侧椎旁肌Ⅰ型肌纤维群化现象,对照组未观察到肌纤维群化现象.CS组的肌纤维群化程度显著高于AⅠS组(P＜0.05),AIS组中Cobb角＞50°的患者肌纤维群化程度显著高于Cobb角≤50°的患者(P＜0.05).结论脊柱侧凸凸侧椎旁肌Ⅰ型肌纤维群化现象系继发性改变,且与侧凸的严重性呈正相关.

Objective To study fiber type grouping of paravertebral muscles in adolescent idiopathic scoliosis （AIS） and analyze its relationship with the development and progression of AIS. Methods AIS group had 20 cases with average age of 15.3 years and average Cobb angle of 56.8 degrees, including 11 cases with Cobb angle 〉 50 degrees and 9 cases with Cobb angle ≤50. The apex vertebraes were from T7 to T12. Congenital scoliosis （CS） group had 11 cases with average age of 13.9 years and average Cobb angle of 66.7 degrees. The apex vertebraes were from T7 to T12. Control group had 10 cases without scoliosis. The paravertebral muscles in apical vertebral region in AIS and CS groups and in non-disease involved region in control group were analyzed. Results Type I fibers grouping on the convex side was observed in AIS and CS groups and no fiber type grouping was observed in control group. The degree of fiber type grouping of CS group was more severe than that of AIS group（P〈0.05）. In AIS group, the degree of fiber type grouping of patients with Cobb angle 〉50 degrees was more severe than that of patients with Cobb angle ≤50（ P〈0.05）. Conclusion The fiber type grouping of paravertebral muscles is secondary to idiopathic scoliosis.