初发腰腿痛年轻人群中腰椎间盘退变与椎旁肌群改变的相关性

Correlation between lumbar disc degeneration and paraspinal muscle changes in young adults with lumbago and leg pain

目的探索初发腰腿痛年轻人群中腰椎间盘退变与椎旁肌群改变的相关性。方法收集2016年1月至2018年6月本院诊治的36例腰间盘突出症患者,分析对比正常人与腰间盘突出症患者之间椎旁肌肉群上是否存在差异。结果实验组多裂肌的MVr明显低于对照组的多裂肌的MVr,差异有统计学意义(P<0.05)。实验组的腰大肌和最长肌的MVr与对照组相比较,差异无统计学意义。对照组的椎间盘退变分级与脂肪浸润分级明显高于对照组椎间盘退变分级与脂肪浸润分级,差异有统计学意义(P<0.05)。Spearman相关分析发现,腰间盘突出患者的椎旁肌肉群的MVr与椎间盘退变之间存在中度相关性(腰大肌r=0.621,P<0.05;多裂肌r=0.632,P<0.05,最长肌r=0.521,P<0.05),腰间盘突出患者的椎旁肌肉群的MVr与脂肪浸润之间存在低度相关性(腰大肌r=0.207,P<0.05;多裂肌r=0.276,P<0.05,最长肌r=0.29,P<0.05)。椎间盘退变与脂肪浸润分级之间无相关性(r=-0.112,P>0.05)。结论腰间盘突出患者的腰大肌、多裂肌及最长肌与椎间盘退变之间存在中度相关性,其中多裂肌最为重要。椎间盘退变与脂肪浸润分级之间无相关性。

Objective To explore the correlation between lumbar intervertebral disc degeneration and paravertebral muscle group changes in young people with primary low back and leg pain. Methods 36 patients with lumbar disc herniation were collected from January 2016 to June 2018. The difference of paravertebral muscles between normal people and patients with lumbar disc herniation were analyzed and compared. Results The MVR of the experimental group was significantly lower than that of the control group (P<0.05). There was no significant difference in MVR between the experimental group and the control group. The grade of intervertebral disc degeneration and fat infiltration in the control group were significantly higher than those in the control group (P<0.05). Spearman correlation analysis showed that there was a moderate correlation between MVr and intervertebral disc degeneration in patients with lumbar disc herniation (psoas major r=0.621, P<0.05;polyfidus r=0.632, P<0.05;longissimus longissimus r=0.521, P<0.05). There was a low correlation between MVr and fat infiltration in patients with lumbar disc herniation.(psoas major r= 0.207, P<0.05;r=0.276, P<0.05, longissimus r=0.29, P<0.05). There was no correlation between intervertebral disc degeneration and fat infiltration grade (r=-0.112, P>0.05). Conclusion There was a moderate correlation between psoas major, polyfidus and longissimus muscle and intervertebral disc degeneration in patients with lumbar disc herniation, and polyfidus is the most important. There was no correlation between intervertebral disc degeneration and fat infiltration grade.