腰椎间盘突出与腰大肌横断面积关系的CT探讨

RELATIONSHIP BETWEEN THE TRANSVERSE AREA OF THE PSOAS MUSCLE AND LUMBAR DISC HERNIATION BY CT

目的 ::CT扫描测量腰大肌横断面积 ,探讨其与腰椎间盘突出的关系。方法 :选择 138例临床与CT诊断为腰椎间盘突出的病人 ,在L4～ 5和L5～S1,间隙水平测量双侧腰大肌横断面积 ,并与年龄、性别、身高、体重等身体条件相似的无腰椎间盘突出的对照组相比较。结果对照组中腰大肌横断面积男性较女性明显增大 (P <0 .0 5 ) ;男性腰大肌横断面积在腰椎间盘突出组较正常对照组减小 (P <0 .0 5 ) ;双侧腰大肌横断面积的差值 ,男、女性腰椎间盘突出症组均高于相应对照组 (P值均小于 0 .0 1) ;L4～ 5或L5～S1腰椎间盘突出均可伴腰大肌变细萎缩 ,左侧或右侧腰大肌变细萎缩伴有同侧外后 (左后、右后 )腰椎间盘突出发生率较高 (6 5 .4 3%、70 .5 1% )。结论 :双侧腰大肌不对称及腰大肌变细萎缩可能均是腰椎间盘突出的解剖因素之一。

Objective:To determine the relationship between the transverse area of the psoas muscle and lumbar disc herniation. Methods:The transverse area of the psoas muscles were measured at the level of L 4～5 and L 5～S 1 in 138 randomly selected lumbar disc herniation patients and 138 matched (age, gender, height and weight) healthy controls. Results:The transverse area of psoas muscle was significantly larger in male than in female, but it had not significant difference between right and left in control group. The difference between right and left transverse area of the psoas muscle was significantly bigger in the lumbar disc herniation patient group than in the control group. The transverse area of the psoas muscle in male was significantly smaller in the lumbar disc herniation patient group than in the control group. Both L 4～5 and L 5～S 1 lumbar disc herniation may accompanied by the atrophy of psoas muscle. The left or fight psoas muscle atrophy was more often accompanied by the same side of lumbar disc herniation(the incidence of each was 65.43%, 70.51%).Conclusion:Both the asymmetry between right and left psoas muscles and the amyotrophy or attenuation of the psoas muscle are probably the anatomical factors which lead to lumbar disc herniation.