腰椎退行性侧凸患者椎旁肌的形态学改变

Morphological changes of paravertebral muscles in patients with lumbar degenerative scoliosis

目的观察腰椎退行性侧凸患者两侧椎旁肌的形态学改变,分析其临床意义。方法回顾性分析我院2015年1月-2017年12月住院的84例腰椎退变性侧凸患者。按患者顶椎位置分为3组。A组:顶椎位于L2-3椎间盘,B组:顶椎位于L3椎体,C组:顶椎位于L3-4椎间盘。使用image pro PLus软件测量椎旁肌肉相关数据。结果(1)A组顶椎节段多裂肌(MF)面积比凸侧大于凹侧,MF脂肪浸润程度凸侧小于凹侧;(2)腰大肌(PS)面积比凸侧小于凹侧,PS脂肪浸润程度凸侧小于凹侧。(3)A、B、C 3组在顶椎上一个及下一个椎间盘平面与顶椎椎间盘平面有相似的结果。结论退行性侧凸患者凸凹侧椎旁肌退变程度不同,凹侧大于凸侧,退变节段主要发生于顶椎上、下各一节段。且肌肉退变主要以肌肉的脂肪浸润程度增加为主。

Objectives To observe the morphological changes of paraspinal muscles on both sides of lumbar degenerative patients,and to analyze its clinical significance.Methods A retrospective analysis of 84 patients with lumbar degenerative lumbar stenosis who were hospitalized from January 2015 to December2017 in our hospital was performed.The patients were divided into the following three groups:group A:the parietal vertebra was located at the L2-3 intervertebral disc,group B:the parietal vertebra was located at the L3 vertebral body,and group C:the parietal vertebra was located at the L3-4 intervertebral disc.The data of paraspinal muscles were measured by image pro PLus software.Results(1)In group A,the area of the multifissure muscle(MF)in the apical vertebra segment was larger than that in the concave side.The degree of MF fat infiltration in the convex side was smaller than that in the concave side.(2)The area ratio of the psoas major muscle(PS)in the convex side was smaller than that in the concave side,and the fat infiltration degree.(3)Groups A,B and C had similar results on the upper and next intervertebral disc plane of the parietal vertebra.Conclusions In patients with degenerative scoliosis,the degree of muscle degeneration in the convex and concave side is different,the concave side is larger than the convex side,and the degenerative segment mainly occurs in the upper and lower segments of the parietal vertebra.Muscle degeneration is mainly caused by the increasing of fat infiltration of muscle.