腰椎后部结构的MRI表现与不同病程非特异性腰痛的关系

Relationship between MRI findings of posterior lumbar elements and different stages of non-specific low back pain

目的:探讨腰椎后部结构的MRI表现与不同病程非特异性腰痛的关系.方法:收集临床诊断为腰痛并行MRI检查的患者64例,按照腰痛时间分为急性组(<1个月)、亚急性组(1~3个月)、慢性组(>3个月).另选取14例行MRI体检的患者作为对照组.分析各组L4~5水平两侧多裂肌厚度、面积、脂肪浸润程度及其皮下或椎后旁肌肉水肿,以及两侧小关节退变征象的分布特征.结果:各组间多裂肌厚度、面积及小关节退变征象差异均无统计学意义(均P>0.05).慢性组与对照组多裂肌脂肪浸润程度存在差异(P<0.05);皮下或椎后旁肌肉水肿,慢性组发生率均高于其他组(P<0.05).结论:多裂肌脂肪浸润程度、皮下或椎后旁肌肉水肿可能与慢性腰痛有关;腰椎后部结构的MRI表现与急性、亚急性腰痛关系并不明确.

Objective: To investigate the relationship between the MRI findings of posterior lumbar elements and different stages of non-specific low back pain. Methods: A total of 63 patients with low back pain underwent lumbar MRI examinations were divided into acute group (<1 month),sub-acute group (1~3 months) and chronic group (>3 months) according to the time of onset. Forteen healthy subjects underwent lumbar MRI examinations served as a control group. The distribution difference of thickness, cross-sectional area (CSA) of lumbar multifidus muscles in L4.5 level, extent of fat soakage in multifidus muscles, subcutaneous/paraspinal muscles edema and facet joint degeneration symptom in four groups was analyzed. Results: Thickness, CSA of lumbar multifidus muscle, facet joint degeneration symptom had no statistical difference within four groups. Extent of fat soakage in multifidus muscles between chronic group and control group had statistical difference, and the incidence of subcutaneous/paraspinal muscles edema in chronic group was significantly higher than the other three groups. Conclusions: Extent of fat soakage in multifidus muscles, subcutaneous/paraspinal muscles edema are probably associated with chronic low back pain. The relationship between the MRI findings of posterior lumbar elements and acute, sub-acute groups are not clear.