单侧腰痛患者腰椎多裂肌萎缩相关因素研究

目的探讨单侧腰痛患者多裂肌萎缩的相关因素。方法单侧腰痛患者62例，记录腰痛时间长短，进行视觉模拟疼痛（VAS）评分和Oswestry功能障碍指数（ODI）评分，腰椎MRI进行病变节段多裂肌萎缩评估。结果单侧腰痛病史3~42个月，平均（16.6±8.3）个月；VAS评分5.6±1.2；ODI评分（61.2±9.6）%。疼痛侧多裂肌净横截面积（731.2±192.6）mm2，非疼痛侧多裂肌净横截面积（862.5±228.1）mm2，差异有统计学意义（P＜0.01）。疼痛侧多裂肌T2信号比率2.02±0.21，非疼痛侧多裂肌T2信号比率1.75±0.15，差异有统计学意义（P＜0.01）。以非疼痛侧为标准，疼痛侧多裂肌萎缩（15.3±4.9）%，T2信号比率增高（13.3±6.8）%，均与腰痛病史时间长短、VAS疼痛评分及ODI功能障碍指数呈正相关（P＜0.01）。结论腰痛病史时间长短、疼痛及功能障碍程度是引起腰痛患者多裂肌萎缩的相关因素。

Factors related to lumbar multifidus muscle atrophy in patients with unilateral low back pain

Objective To analyze the related factors to multifidus muscle atrophy in patients with unilateral low back pain （LBP）. Methods Sixty- two patients with unilateral LBP underwent magnetic resonance imaging （MRI） examination, and the medical history, visual analogue scale（VAS） and Oswestry disability index（ODI） were reviewed retrospectively. Results The his-tory of unilateral LBP was 16.6 ±8.3 months （3~42months）, VAS score was 5.6 ±1.2, and ODI was 61.2 ±9.6%. The lean cross- sectional area （CSA） of multifidus muscle was 731.2±192.6mm2 at the ipsilateral side of LBP, significantly lower than that at the contralateral side （862.5±228.1mm2, P〈0.001）. The T2 signal intensity ratio of multifidus muscle was 2.02±0.21at the ipsi-lateral side of LBP, significantly higher than that at the contralateral side （1.75±0.15, P〈0.001）. Compared to contralateral multi-fidus muscle, the reduction of lean CSA was 15.3±4.9%, and the increase of T2 signal intensity ratio was 13.3±6.8%at the LBP side, and both were significantly correlated with the medical history, VAS score and ODI value. Conclusion The length of medi-cal history, VAS score and ODI were factors related to multifidus muscle atrophy in patients with LBP.