{"title":"椎旁肌肉退化对退行性脊柱侧凸患者腰椎和骨盆矢状位对齐的影响","authors":"Linyan Liu, Zehua Jiang, Xuanhao Fu, Yuelin Cheng, Sa Feng, Mengmeng Zhou, Xinyan Zhao, Rusen Zhu","doi":"10.1177/21925682241274729","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To explore the relationship between lumbar spine muscle mass and lumbar pelvic sagittal parameters in patients with degenerative scoliosis.</p><p><strong>Methods: </strong>This study included ADS patients who were treated in our hospital from 2019 to 2023. The spinal parameters were evaluated through X-rays, and the relative muscle volume (RMV) and fat infiltration (FI) were measured through three-dimensional reconstruction. Patients were categorized into 3 groups based on SRS-Schwab sagittal balance correction (0, +, ++), and into 3 groups based on GAP score (proportioned, moderately dis-proportioned, severely dis-proportioned). Finally, patients were classified into low-quality and high-quality groups based on the FI of Paraspinal muscles (PSM).</p><p><strong>Results: </strong>The study included a total of 63 patients. Significant statistical differences were observed in the FI and RMV of MF, ES and PS among patients classified by SRS-Schwab PT classification. Additionally, significant statistical differences were found in the RMV of MF and PS among patients classified by SRS-Schwab PI-LL classification and GAP score. Furthermore, a significant correlation was found between the FI and RMV of PSM and lumbopelvic sagittal parameters. The ordinal regression model analysis revealed that FI of ES significantly impacted PT imbalance, while RMV of MF significantly impacted PI-LL imbalance. Moreover, significant differences were noted in PT and PI between the low-quality and high-quality multifidus groups.</p><p><strong>Conclusions: </strong>As sagittal imbalance worsens, PSM degeneration also intensifies, primarily characterized by an increase in FI and a decrease in RMV. Notably, PT and PI-LL are positively correlated with RMV and negatively correlated with FI.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Paravertebral Muscle Degeneration on Lumbar and Pelvic Sagittal Alignment in Patients With Degenerative Scoliosis.\",\"authors\":\"Linyan Liu, Zehua Jiang, Xuanhao Fu, Yuelin Cheng, Sa Feng, Mengmeng Zhou, Xinyan Zhao, Rusen Zhu\",\"doi\":\"10.1177/21925682241274729\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To explore the relationship between lumbar spine muscle mass and lumbar pelvic sagittal parameters in patients with degenerative scoliosis.</p><p><strong>Methods: </strong>This study included ADS patients who were treated in our hospital from 2019 to 2023. The spinal parameters were evaluated through X-rays, and the relative muscle volume (RMV) and fat infiltration (FI) were measured through three-dimensional reconstruction. Patients were categorized into 3 groups based on SRS-Schwab sagittal balance correction (0, +, ++), and into 3 groups based on GAP score (proportioned, moderately dis-proportioned, severely dis-proportioned). Finally, patients were classified into low-quality and high-quality groups based on the FI of Paraspinal muscles (PSM).</p><p><strong>Results: </strong>The study included a total of 63 patients. Significant statistical differences were observed in the FI and RMV of MF, ES and PS among patients classified by SRS-Schwab PT classification. Additionally, significant statistical differences were found in the RMV of MF and PS among patients classified by SRS-Schwab PI-LL classification and GAP score. Furthermore, a significant correlation was found between the FI and RMV of PSM and lumbopelvic sagittal parameters. The ordinal regression model analysis revealed that FI of ES significantly impacted PT imbalance, while RMV of MF significantly impacted PI-LL imbalance. Moreover, significant differences were noted in PT and PI between the low-quality and high-quality multifidus groups.</p><p><strong>Conclusions: </strong>As sagittal imbalance worsens, PSM degeneration also intensifies, primarily characterized by an increase in FI and a decrease in RMV. 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引用次数: 0
摘要
研究设计目的:探讨退行性脊柱侧凸患者腰椎肌肉质量与腰椎骨盆矢状参数之间的关系:探讨退行性脊柱侧凸患者腰椎肌肉质量与腰椎骨盆矢状参数之间的关系:本研究纳入了2019年至2023年在我院接受治疗的ADS患者。通过X光片评估脊柱参数,通过三维重建测量相对肌肉体积(RMV)和脂肪浸润(FI)。根据SRS-Schwab矢状面平衡校正将患者分为三组(0、+、++),根据GAP评分将患者分为三组(比例失调、中度比例失调、严重比例失调)。最后,根据脊柱旁肌肉(PSM)的FI将患者分为低质量组和高质量组:研究共纳入 63 名患者。根据 SRS-Schwab PT 分类法划分的患者中,MF、ES 和 PS 的 FI 和 RMV 存在显著的统计学差异。此外,根据 SRS-Schwab PI-LL 分级和 GAP 评分分类的患者,其 MF 和 PS 的 RMV 也存在明显的统计学差异。此外,还发现 PSM 的 FI 和 RMV 与腰椎矢状位参数之间存在明显的相关性。序数回归模型分析显示,ES的FI对PT失衡有显著影响,而MF的RMV对PI-LL失衡有显著影响。此外,低质量组和高质量组的多裂肌在PT和PI方面存在明显差异:结论:随着矢状不平衡的恶化,PSM退化也会加剧,主要表现为FI增加和RMV减少。值得注意的是,PT 和 PI-LL 与 RMV 呈正相关,而与 FI 呈负相关。
Effect of Paravertebral Muscle Degeneration on Lumbar and Pelvic Sagittal Alignment in Patients With Degenerative Scoliosis.
Study design: Retrospective study.
Objectives: To explore the relationship between lumbar spine muscle mass and lumbar pelvic sagittal parameters in patients with degenerative scoliosis.
Methods: This study included ADS patients who were treated in our hospital from 2019 to 2023. The spinal parameters were evaluated through X-rays, and the relative muscle volume (RMV) and fat infiltration (FI) were measured through three-dimensional reconstruction. Patients were categorized into 3 groups based on SRS-Schwab sagittal balance correction (0, +, ++), and into 3 groups based on GAP score (proportioned, moderately dis-proportioned, severely dis-proportioned). Finally, patients were classified into low-quality and high-quality groups based on the FI of Paraspinal muscles (PSM).
Results: The study included a total of 63 patients. Significant statistical differences were observed in the FI and RMV of MF, ES and PS among patients classified by SRS-Schwab PT classification. Additionally, significant statistical differences were found in the RMV of MF and PS among patients classified by SRS-Schwab PI-LL classification and GAP score. Furthermore, a significant correlation was found between the FI and RMV of PSM and lumbopelvic sagittal parameters. The ordinal regression model analysis revealed that FI of ES significantly impacted PT imbalance, while RMV of MF significantly impacted PI-LL imbalance. Moreover, significant differences were noted in PT and PI between the low-quality and high-quality multifidus groups.
Conclusions: As sagittal imbalance worsens, PSM degeneration also intensifies, primarily characterized by an increase in FI and a decrease in RMV. Notably, PT and PI-LL are positively correlated with RMV and negatively correlated with FI.
期刊介绍:
Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).