颈部肌肉紧张度检测方法与评价指标的临床研究进展

The clinical research progress of neck muscle tensity detection methods and evaluation index

颈部肌群具有复杂的解剖学和生理学特点,对维持颈椎稳定性和参与颈部活动具有重要作用。长期低头会对颈部肌肉造成不可逆转的损伤,临床表现为颈项部僵硬、肌张力增高,严重者出现条索状肌肉痉挛,由其导致的持续时间长达3个月以上的疼痛称为慢性颈痛。随着人群中慢性颈痛发病率越来越高,相关的个案报道及临床研究也日渐增多。目前普遍认为颈部肌肉持续性非自主性高张力状态是慢性颈痛的首要病理机制。对于颈部肌肉紧张度的客观、定量分析和评价有助于预测慢性颈痛的发生、阐述其发病机制和制定治疗措施,目前已逐步成为该领域的主要发展趋势。近年来随着辅助医学的发展,评价手段发生了日新月异的变革,这为临床研究提供了多种选择。归纳总结目前比较主流的几种针对颈部肌肉紧张度的检测方法,分别介绍了实时剪切波弹性成像技术、表面肌电图、磁共振成像和弥散张量成像,从其发展历史引入,详细阐述各项技术的工作原理,通过回顾国内外经典病的临床研究,深入分析各项技术在颈部肌肉检测领域的研究现状、发展趋势、潜在优势和局限,评价杨氏模量值、积分肌电值、均方根振幅、平均功率频率、中位频率、横截面积和表观弥散系数等指标的研究成效。旨在总结经验、指导临床,加深对慢性颈痛微观发病机制的认知和理解,为探索新型检测手段提供理论基础,为相关领域提供全方位、多层次、立体化的新型临床诊疗策略,并为慢性颈痛的后续研究提供新方法和新思路。

Cervical muscle group has complex anatomical and physiological characteristics,which plays an important role in maintaining cervical stability and participating in cervical activity.Long-term bow of the head will cause irreversible injury to the neck muscle.The clinical manifestations are stiffness of the neck,and increased muscle tension.In severe cases,muscle spasms are like stripes.The pain caused by it for more than 3 months is called chronic neck pain(CNP).With the increasing incidence of chronic neck pain in the population,the related case reports and clinical studies are also increasing.At present,it is generally believed that persistent non-autonomous hypertension of neck muscle is the primary pathological mechanism of chronic neck pain.For the objective,quantitative analysis and evaluation of neck muscle tension is helpful to predict the occurrence of chronic neck pain,explain its pathogenesis and formulate treatment measures,which has gradually become the main development trend in this field.In recent years,with the development of auxiliary medicine,evaluation methods have changed with each passing day,which provides a variety of options for clinical research.In this paper,several mainstream detection methods of cervical muscle tension are summarized,and the shear wave elastography technology,surface electromyography,magnetic resonance imaging and diffusion tensor imaging are introduced respectively.Their development history,and the working principle of each technology aredescribed in detail.By reviewing the classical clinical research cases at domestic and abroad,the research status of each technology in the field of cervical muscle detection is deeply analyzed.The development trend,potential advantages and limitations of Yang's modulus,integrated electromyography,root mean square value,mean power frequency,median frequency,cross sectional area and apparent diffusion coefficient were evaluated.The purpose of this paper is to summarize experience,guide clinic,deepen the understanding of microcosmic pathogenesis of chronic neck pain,provide theoretical basis for exploring new detection methods,provide omni-directional,multi-level and three-dimensional new clinical diagnosis and treatment strategies for related fields,and provide new methods and ideas for the follow-up study of chronic neck pain.