不同体位下青少年特发性脊柱侧凸患者椎旁肌的超声影像测量与分析

目的　超声评估青少年特发性脊柱侧凸（AIS）患者脊柱两侧椎旁肌的对称性和形态学特征，为AIS运动治疗提供线索和依据。 方法　收集23例AIS患者（患者组）与23例无脊柱侧凸的青少年（对照组），应用超声对两组受试者在休息位（腰背部肌肉取俯卧位、腹部肌肉取仰卧位）、站立位下测量椎旁肌（T12~L5水平竖脊肌、T12~S1水平多裂肌、腰方肌和腹横肌）厚度，计算肌肉厚度变化率。 结果　休息和站立位时，AIS患者主弯曲线T12~L4水平竖脊肌、T12~S1水平多裂肌、腰方肌和腹横肌（仅休息位）凸侧厚度均小于凹侧（P<0.05）；休息和站立位时，AIS患者凸侧竖脊肌、多裂肌、腰方肌和腹横肌（仅休息位）厚度均小于对照组（P<0.05）；AIS患者凹凸两侧的竖脊肌收缩厚度变化率均小于对照组（P<0.05）。 结论　休息和站立位时，AIS患者主弯曲线多个椎体节段椎旁肌对称性不良，较对照组凸侧椎旁肌厚度薄。

Ultrasound imaging measurement and analysis of paravertebral muscles in adolescent patients with idiopathic scoliosis at different positions

Objective　To evaluate the symmetry and morphologic characteristics of the paravertebral muscle in adolescent idiopathic scoliosis (AIS) patients by ultrasound, so as to provide basis for the exercise treatment of AIS.　Methods 　A total of forty-six adolescents (23 with AIS as a patient group and 23 without AIS as a control group) were collected. The thickness of paravertebral muscle (erector spinae at T12~L5 vertebral levels, multifidus at T12~S1 vertebral levels, quadratus lumborum and transversus abdominis muscle) was measured by ultrasound in resting position (prone position of lumbar and back muscles, supine position of abdominal muscles) and standing position. The rate of muscle thickness change was calculated.　Results　At resting position and standing position, the convex side thickness of erector spinae at T12~L4 vertebral levels, the multifidus of T12~S1 vertebral levels, quadratus lumborum and transversus abdominis muscle (only the rest position) of the main bending line in AIS patients was lower than that of the concave side (P<0.05). At resting position and standing position, the change rates of spinal erector contraction thickness on convex side and concave side in AIS group was lower than that in the control group (P<0.05).　Conclusions　At resting position and standing position, compared with the control group, the paraspinal muscles of AIS patients were asymmetrical in multiple vertebral segments, and the thickness of the convex paraspinal muscles were thinner in the AIS patients.