探讨退行性腰椎管狭窄患者椎旁肌横截面积的改变及临床意义
发布时间：2018-10-30 08:57
【摘要】：目的：探讨退行性腰椎管狭窄(Degenerative Lumbar spinal stenosis DLSS)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2012年9月份至2014年2月份的102例退行性腰椎管狭窄患者为DLSS组,50名男性和52名女性；年龄45-67岁,平均：55.56±9.54岁。选取在我院体检的资料齐全的健康人102例为对照组,49名男性,53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：DLSS组与对照组对比在L5层面,双侧腰大肌CSA、双侧竖脊肌CSA以及右侧多裂肌CSA均减小,在L4层面右侧竖脊肌CSA减小。DLSS组双侧椎旁肌对比,在L4、L5层面多裂肌右侧CSA减小,在L3、L4层面竖脊肌双侧对比右侧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。DLSS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L5层面DLSS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：退行性腰椎管狭窄患者腰大肌、多裂肌和竖脊肌CSA减小,肌肉发生萎缩,但不能确定退行性腰椎管狭窄与椎旁肌萎缩的因果关系,就目前研究现状而言,退行性腰椎管狭窄患者椎旁肌的改变需要更为系统的研究。
[Abstract]:Objective: to investigate the changes of paraspinal muscle cross-sectional area (cross-sectional area CSA) in patients with degenerative lumbar spinal stenosis (Degenerative Lumbar spinal stenosis DLSS) and its clinical significance. Methods: 102 cases of degenerative lumbar spinal stenosis from September 2012 to February 2014 were selected as DLSS group, 50 males and 52 females, aged 45-67 years (mean: 55.56 卤9.54 years). 102 healthy persons with complete physical examination in our hospital were selected as control group, 49 males and 53 females, aged 45-67 years (mean 53.48 卤6.45). The sex and age of the two groups were matched (p0.05). In this paper, we select T 2 weighted images of L3, L4 and L5 as the measuring plane, and use Image J2x software to measure the CSA, of the paravertebral muscles, including psoas major, polyfissure and vertical spinal muscles, at the horizontal level of L3, L4 and L5 vertebrae, respectively. T test was used to analyze the difference of paravertebral muscle CSA between the two groups, and the ratio of CSA to CSA was compared between the two groups. Results: compared with the control group, in the DLSS group, the CSA of the bilateral erector spinal muscle and the CSA of the right polyfissure muscle in the bilateral psoas major muscle CSA, and the right polyfissure muscle decreased in the L5 level, and the CSA of the right perpendicular spinal muscle decreased in the L4 level, while in the DLSS group, the bilateral paravertebral muscles were compared in L4. The CSA on the right side of the L5 polyfissure muscle was decreased, while on the L3 / L4 level, the CSA of the right side was decreased compared with the bilateral side of the L3 / L4 vertical spinal muscle. Compared with the control group, the CSA of the right side of the vertical spinal muscle decreased in the L3 level, and the ratio of CSA to CSA in the DLSS group was compared with that in the control group in the same segment. It was found that the ratio of CSA to CSA of erector spinal muscle in L5 DLSS group was lower than that of normal group in both sides. Conclusion: in patients with degenerative lumbar spinal stenosis, CSA of psoas major muscle, polyfissure muscle and vertical spinal muscle decrease and muscle atrophy occurs, but the causality between degenerative lumbar spinal stenosis and paraspinal muscle atrophy can not be determined. The changes of paraspinal muscles in patients with degenerative lumbar spinal stenosis 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】：2015
【分类号】：R687.3
本文编号：2299542
[Abstract]:Objective: to investigate the changes of paraspinal muscle cross-sectional area (cross-sectional area CSA) in patients with degenerative lumbar spinal stenosis (Degenerative Lumbar spinal stenosis DLSS) and its clinical significance. Methods: 102 cases of degenerative lumbar spinal stenosis from September 2012 to February 2014 were selected as DLSS group, 50 males and 52 females, aged 45-67 years (mean: 55.56 卤9.54 years). 102 healthy persons with complete physical examination in our hospital were selected as control group, 49 males and 53 females, aged 45-67 years (mean 53.48 卤6.45). The sex and age of the two groups were matched (p0.05). In this paper, we select T 2 weighted images of L3, L4 and L5 as the measuring plane, and use Image J2x software to measure the CSA, of the paravertebral muscles, including psoas major, polyfissure and vertical spinal muscles, at the horizontal level of L3, L4 and L5 vertebrae, respectively. T test was used to analyze the difference of paravertebral muscle CSA between the two groups, and the ratio of CSA to CSA was compared between the two groups. Results: compared with the control group, in the DLSS group, the CSA of the bilateral erector spinal muscle and the CSA of the right polyfissure muscle in the bilateral psoas major muscle CSA, and the right polyfissure muscle decreased in the L5 level, and the CSA of the right perpendicular spinal muscle decreased in the L4 level, while in the DLSS group, the bilateral paravertebral muscles were compared in L4. The CSA on the right side of the L5 polyfissure muscle was decreased, while on the L3 / L4 level, the CSA of the right side was decreased compared with the bilateral side of the L3 / L4 vertical spinal muscle. Compared with the control group, the CSA of the right side of the vertical spinal muscle decreased in the L3 level, and the ratio of CSA to CSA in the DLSS group was compared with that in the control group in the same segment. It was found that the ratio of CSA to CSA of erector spinal muscle in L5 DLSS group was lower than that of normal group in both sides. Conclusion: in patients with degenerative lumbar spinal stenosis, CSA of psoas major muscle, polyfissure muscle and vertical spinal muscle decrease and muscle atrophy occurs, but the causality between degenerative lumbar spinal stenosis and paraspinal muscle atrophy can not be determined. The changes of paraspinal muscles in patients with degenerative lumbar spinal stenosis 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】：2015
【分类号】：R687.3
【参考文献】
相关期刊论文 前1条
1 韦以宗;田新宇;王慧敏;谢冰;;腰大肌与腰椎运动力学关系动物实验研究[J];中国临床解剖学杂志;2011年01期
，本文编号：2299542
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