青少年特发性脊柱侧弯椎旁肌表面肌电信号对称性及与侧弯角度的相关性研究

Correlation study of paravertebral muscle selectromyographic signals symmetry and Cobb angle in adolescent idiopathic scoliosis

目的研究青少年特发性脊柱侧弯椎旁肌凸凹侧表面肌电信号的对称性及其与Cobb角的相关性。方法选择18例青少年特发性脊柱侧弯患者,年龄10~18岁,平均年龄13.56岁;身高140.31~169.24 cm,平均身高157.30 cm;体质量33.50~51.50 kg,平均体质量43.43 kg;坐高75.60~91.72 cm,平均坐高83.51 cm;Cobb角18.50°~45.70°,平均Cobb角32.54°;Risser征0~4;S型8例,C型10例。用人体表面肌电信号监测系统测量并记录站立时静息状态和负重状态下患者椎旁肌顶椎区凸凹两侧的表面肌电信号。采用配对t检验比较患者椎旁肌表面肌电信号凸凹侧均方根值(RMS)的差异性,用Pearson相关性分析患者椎旁肌表面肌电信号凸凹侧RMS的比值与Cobb角的相关性。结果患者椎旁肌顶椎区表面肌电信号凸凹侧RMS差异有统计学意义,凸侧大于凹侧(P<0.05)。站立时负重状态较之于静息状态,这种差异会加大,差值分别是38.048μV和6.362μV。椎旁肌表面肌电信号凸凹侧RMS的比值与Cobb角不存在显著的相关性,只有Cobb角小于30°患者两个参数存在弱相关(r=0.525,P>0.05),但差异无统计学意义。结论青少年特发性脊柱侧弯患者椎旁肌顶椎区表面肌电信号凸侧明显大于凹侧,站立时负重状态这种差异会进一步加大。此外,研究中的青少年特发性脊柱侧弯患者椎旁肌凸凹侧RMS比值与Cobb角无显著的相关性。

Objective To investigate the symmetry of surface electromyographic(sEMG)activity of paravertebral muscle and its correlation with Cobb angle in patients with adolescent idiopathic scoliosis(AIS).Method Eighteen patients with AIS were enrolled,which aged 10-18 years old with mean age of 13.56 years old;height was 140.31-169.24 cm with mean height of157.30 cm;body mass was 33.50-51.50 kg with mean body mass of 43.43 kg;sitting height was 75.60-91.72 cm with mean sitting height of 83.51 cm;Cobb angle was 18.50°-45.70°with mean Cobb angle of 32.54°;Risser sign was 0-4.There were 8 cases of type S and 10 of type C.Human sEMG detection system was used to measure and record sEMG on both sides of convexity and depression of paraspinal muscle parietal region of patients during resting-standing and weight-bearing standing.The paired t test was used to compare the difference in root mean square(RMS)values of paravertebral muscles onconvex and concave sides of sEMG,and Pearson correlation analysis was used to analyze the correlation between ratio of RMS values of convex and concave sides of paravertebral muscles sEMG and Cobb angle.Results The RMS of sEMG of paraspinal muscle on convex side was significantly higher than that of concave side,and the difference was statistically significant(P>0.05),and the difference between weight-bearing standing and static standing was even bigger(38.048μV and 6.362μV respectively).The RMS of sEMG of paraspinal muscle had no significant correlation with Cobb angle regardless of curve location and age(r<0.5,P>0.05).In patients with mild scoliosis(Cobb<30°),there was a weak correlation between 2 parameters(r=0.525,P>0.05),but the difference was no statistically significant.Conclusion It is demonstrated that sEMG activity of paraspinal muscle on convex side is higher than that of concave side,and the difference is even higher during weight-bearing standing.There is no significant correlation between paraspinal muscle RMS ratio and Cobb angle in patients with AIS.