NRS分型及椎旁肌的MRI影像学与腰椎管狭窄症术后改善率的关系

Relationship between NRS classification,MRI imaging of paravertebral muscle and postoperative improvement rate of lumbar spinal stenosis

目的 探讨数字评分量表(NRS)分型及椎旁肌的MRI影像学与腰椎管狭窄症术后改善率的关系。方法 选取本院收治的220例腰椎管狭窄患者作为观察组,选取同期健康体检者100例作为对照组;对受试者NRS分型进行判断,并分析患者竖脊肌横截面积、多裂肌横截面积、多裂肌脂肪浸润程度和竖脊肌脂肪浸润程度;采用日本脊柱外科学会(JOA)下腰痛评分系统对腰椎管狭窄症术后改善率进行分析。结果 对照组NRS分型明显优于观察组,差异有统计学意义(P <0.05);观察组患者竖脊肌横截面积、多裂肌横截面积均明显低于对照组,多裂肌脂肪浸润程度和竖脊肌脂肪浸润程度均明显高于对照组,且差异有统计学意义(P <0.05);术后改善率良好组患者NRS分型、多裂肌脂肪浸润程度和竖脊肌脂肪浸润程度明显低于不良组,术后改善率良好组患者竖脊肌横截面积、多裂肌横截面积均明显高于不良组,差异有统计学意义(P <0.05);腰椎管狭窄症术后改善率与NRS分型、竖脊肌横截面积、多裂肌横截面积呈明显正相关关系,与多裂肌脂肪浸润程度和竖脊肌脂肪浸润程度呈明显负相关关系,差异有统计学意义(P <0.05);腰椎管狭窄症患者NRS分型、竖脊肌横截面积、多裂肌横截面积、多裂肌脂肪浸润程度、竖脊肌脂肪浸润程度均是影响其术后改善率的独立性因素,且差异有统计学意义(P <0.05)。结论 NRS分型及椎旁肌的MRI表现与腰椎管狭窄症术后改善率呈显著相关性关系。

Objective To analyze the relationship between Numeric Rating Scale(NRS)classification and MRI imaging of paravertebral muscle and the postoperative improvement rate of lumbar spinal stenosis.Methods 220 patients with lumbar spi-nal stenosis treated in Hengshui Fourth People's Hospital were collected as the research objects,and 100 healthy subjects were selected as the control objects.We judged the NRS classification of subjects,and observed the cross-sectional area of erector spi-nalis muscle,cross-sectional area of multifidus muscle,fat infiltration degree of multifidus muscle and fat infiltration degree of erector spinalis muscle.Japanese Orthopaedic Association low back pain scoring system was used to investigate the postoperative improvement rate of lumbar spinal stenosis.Results The NRS classification of the control group was significantly better than that of the observation group,and the difference was statistically significant(P<0.05).The cross-sectional area of erector spine muscle and the cross-sectional area of multifidus muscle in the observation group were significantly lower than those in the con-trol group,and the degree of fat infiltration of fissured muscle and erector spine muscle fat infiltration were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The results of NRS classification,poly-fissure muscle fat infiltration and erector spinal muscle fat infiltration in the group with good postoperative improvement rate were significantly lower than those in the poor group,and the cross-sectional area of erector spinal muscle and multi-fidus muscle in the group with good postoperative improvement rate were significantly higher than those in the poor group,and the differences were statistically significant(P<0.05).The improvement rate after lumbar spinal stenosis was positively correlated with NRS classification,erector spinal muscle cross-sectional area and multifidus cross-sectional area and,negatively,correlated with the degree of fat infiltration of fissured muscle and the degree of fat infiltration of erector spinal muscle,and the difference was statis-tically significant(P<0.05).NRS classification,erector spinal muscle cross-sectional area,multifidus cross-sectional area,polyfida muscle fat infiltration,and erector spinal muscle fat infiltration were independent factors affecting the postoperative im-provement rate of patients with lumbar spinal stenosis,and the differences were statistically significant(P<0.05).Conclusion NRS classification and MRI imaging of paravertebral muscle are significantly correlated with the postoperative improvement rate of lumbar spinal stenosis.