【摘要】：目的：探討退行性腰椎管狹窄(Degenerative Lumbar spinal stenosis DLSS)患者椎旁肌橫截面積(cross-sectional area CSA)是否發(fā)生改變及其臨床意義。方法：采用回顧性研究方法,選取2012年9月份至2014年2月份的102例退行性腰椎管狹窄患者為DLSS組,50名男性和52名女性；年齡45-67歲,平均：55.56±9.54歲。選取在我院體檢的資料齊全的健康人102例為對(duì)照組,49名男性,53名女性,年齡45-67歲,平均53.48±6.45,兩組間性別、年齡相匹配(p0.05)。選取MRI圖像T2加權(quán)像L3、L4、L5椎體下緣作為選取測(cè)量平面,應(yīng)用Image J2x軟件分別測(cè)量?jī)山ML3、L4和L5椎體下緣水平線兩側(cè)椎旁肌,包括腰大肌、多裂肌和豎脊肌的CSA,所得數(shù)據(jù)使用t檢驗(yàn)分析兩組椎旁肌CSA的差異,對(duì)比同一組雙側(cè)椎旁肌是否存在差異,并將豎脊肌CSA與多裂肌CSA的比值進(jìn)行兩組之間對(duì)比。結(jié)果：DLSS組與對(duì)照組對(duì)比在L5層面,雙側(cè)腰大肌CSA、雙側(cè)豎脊肌CSA以及右側(cè)多裂肌CSA均減小,在L4層面右側(cè)豎脊肌CSA減小。DLSS組雙側(cè)椎旁肌對(duì)比,在L4、L5層面多裂肌右側(cè)CSA減小,在L3、L4層面豎脊肌雙側(cè)對(duì)比右側(cè)CSA減小。對(duì)照組雙側(cè)椎旁肌對(duì)比,在L3層面豎脊肌右側(cè)CSA減小。DLSS組與對(duì)照組在同一節(jié)段對(duì)比豎脊肌CSA與多裂肌CSA的比值,發(fā)現(xiàn)在L5層面DLSS組豎脊肌CSA與多裂肌CSA的比值在雙側(cè)均較正常組減小。結(jié)論：退行性腰椎管狹窄患者腰大肌、多裂肌和豎脊肌CSA減小,肌肉發(fā)生萎縮,但不能確定退行性腰椎管狹窄與椎旁肌萎縮的因果關(guān)系,就目前研究現(xiàn)狀而言,退行性腰椎管狹窄患者椎旁肌的改變需要更為系統(tǒng)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 鹵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 鹵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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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相關(guān)期刊論文 前1條

1 韋以宗;田新宇;王慧敏;謝冰;;腰大肌與腰椎運(yùn)動(dòng)力學(xué)關(guān)系動(dòng)物實(shí)驗(yàn)研究[J];中國(guó)臨床解剖學(xué)雜志;2011年01期

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本文編號(hào)：2299542