探讨退行性腰椎滑脱患者椎旁肌横截面积的改变及临床意义

发布时间：2018-04-24 09:44

本文选题：退行性腰滑脱 + 椎旁肌　；参考：《新疆医科大学》2016年硕士论文

【摘要】：目的:探讨退行性腰椎滑脱(Degenerative Lumbar spondylolisthesis DLS)患者椎旁肌横截面积(cross-sectional area CSA)是否发生改变及其临床意义。方法:采用回顾性研究方法,选取2013年9月份至2015年2月份的102例退行性腰椎滑脱患者为DLS组,45名男性和57名女性;年龄40-69岁,平均:54.3±8.11岁。选取在我院体检的资料齐全的健康人102例为对照组,47名男性,55名女性,年龄45-67岁,平均53.48±6.45,两组间性别、年龄相匹配(p0.05)。选取MRI图像T2加权像L3、L4、L5椎体下缘作为选取测量平面,应用Image J2x软件分别测量两组L3、L4和L5椎体下缘水平线两侧椎旁肌,包括腰大肌、多裂肌和竖脊肌的CSA,所得数据使用t检验分析两组椎旁肌CSA的差异,对比同一组双侧椎旁肌是否存在差异,并将竖脊肌CSA与多裂肌CSA的比值进行两组之间对比。结果:DLS组与对照组对比在L5层面,双侧多裂肌CSA及双侧腰背伸肌CSA均减小,在L4层面右侧腰大肌CSA及左侧腰背伸肌CSA均减小,在L3层面双侧腰大肌CSA均减小、双侧多裂肌CSA及双侧腰背伸肌CSA均增大。DLS组双侧椎旁肌对比,在L3、L4层面多裂肌右侧CSA减小,在L4层面竖脊肌双侧对比右侧CSA减小,在L4层面腰背伸肌双侧对比右侧CSA减小。对照组双侧椎旁肌对比,在L3层面竖脊肌右侧CSA减小。DLS组与对照组在同一节段对比竖脊肌CSA与多裂肌CSA的比值,发现在L3层面DLS组竖脊肌CSA与多裂肌CSA的比值在双侧均较正常组减小。结论:退行性腰椎滑脱患者腰大肌、多裂肌CSA减小,肌肉发生萎缩,而竖脊肌肉CSA变化较多裂肌变化小,就目前研究现状而言,退行性腰椎滑脱患者椎旁肌的改变需要更为系统的研究。
[Abstract]:Objective: to investigate whether the cross-sectional area of paravertebral muscle in patients with degenerative lumbar spondylolisthesis (DLSs) and its clinical significance. Methods: 102 cases of degenerative lumbar spondylolisthesis from September 2013 to February 2015 were selected as DLS group with 45 males and 57 females aged 40-69 years with an average of 54.3 卤8.11 years old. 102 healthy persons with complete physical examination in our hospital were selected as control group. There were 47 males and 55 females aged 45-67 years (mean 53.48 卤6.45). Using T _ 2 weighted MRI images as the measuring plane, the paravertebral muscles, including the psoas major muscles, were measured by Image J2x software in two groups of lateral paravertebral muscles, including the psoas major muscle, at the horizontal level of the lower margin of the L3P L4 and L5 vertebrae, respectively. The difference of CSA in paravertebral muscles between the two groups was analyzed by t test, and the ratio of CSA to CSA was compared between the two groups. Results compared with the control group, the CSA of bilateral polyfissure muscle and the CSA of bilateral dorsal extensor psoas decreased, the CSA of right psoas major and the CSA of left extensor psoas decreased in L4, and CSA of bilateral psoas major decreased in L3. The CSA of bilateral polyfissure muscle and the CSA of bilateral dorsalis dorsalis muscle were increased. In DLS group, the right side CSA of polyfissure muscle was decreased in L3 / L4 level, the CSA of right side was decreased in L4 level, and the right CSA was decreased in L4 level compared with both sides of extensor psoas dorsalis muscle. Bilateral paravertebral muscles were compared in the control group, the CSA of the right side of the erector spinal muscle decreased at the L3 level. The ratio of CSA to CSA of the vertical spinal muscle was compared with that of the control group in the same segment. It was found that the ratio of CSA to CSA of erector spinal muscle in L3 DLS group was lower than that of normal group in both sides. Conclusion: in degenerative lumbar spondylolisthesis patients, the CSA of polyfissure muscle decreases and the muscle atrophy occurs, while the CSA of vertical spine muscle changes less than that of polycleft muscle. The changes of paravertebral muscles in degenerative lumbar spondylolisthesis need more systematic study.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R681.5

【相似文献】